=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790653988
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARIEL MILLER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2025
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9581 FM 1097 SUITE 120
-----------------------------------------------------
City | WILLIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-890-8000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9851 FM 1097 RD W STE 120
-----------------------------------------------------
City | WILLIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77318-5852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-890-8000
-----------------------------------------------------
Fax | 833-973-0788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1009893
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------