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General NPI Number Information
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NPI Number | 1679620405
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Entity Type | Organization
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Legal Business Name | BROWNWOOD M. D. ANESTHESIA
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2222 HIGHWAY 377 S SUITE #11
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City | BROWNWOOD
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State | TX
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Zip | 76801-3905
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Country | US
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Telephone | 325-643-6100
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Fax | 325-646-9977
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Provider Business Mailing Address
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Address Line | 2222 HIGHWAY 377 S SUITE #11
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City | BROWNWOOD
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State | TX
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Zip | 76801-3905
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Country | US
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Telephone | 325-643-6100
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Fax | 325-646-9977
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Authorized Official
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Title or Position | OWNER
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Name | DR. WAYDE DIRK MILLER
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Credential | M. D.
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Telephone | 325-643-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | J5616
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License Number State | TX
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