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General NPI Number Information
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NPI Number | 1588697163
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Entity Type | Organization
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Legal Business Name | LANE R MILLER MD PA
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1721 BIRMINGHAM RD
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City | COLLEGE STATION
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State | TX
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Zip | 77845-4082
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Country | US
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Telephone | 979-764-1474
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Fax | 979-764-9249
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Provider Business Mailing Address
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Address Line | 1721 BIRMINGHAM DR
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City | COLLEGE STATION
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State | TX
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Zip | 77845
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Country | US
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Telephone | 979-764-1474
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Fax | 979-764-9249
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Authorized Official
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Title or Position | OWNER
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Name | DR. LANE R MILLER
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Credential | MD
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Telephone | 979-764-1474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L1673
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License Number State | TX
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