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NPI Code Detail

MEDICARE: DR. MARK ALLEN MILLER M.D., D.M.D.

MEDICARE: DR. MARK ALLEN MILLER M.D., D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204E00000XOral & Maxillofacial Surgery (D.M.D.)ME127863FL
21223S0112XOral and Maxillofacial Surgery (Dentist)32796TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083680367
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK ALLEN MILLER M.D., D.M.D.
Provider Business Mailing Address
First Line : PO BOX 40397
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-1397
Country : US
Telephone Number : 270-994-4565
Fax Number : 210-567-2844
Provider Business Practice Location Address
First Line : 8210 FLOYD CURL DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3923
Country : US
Telephone Number : 210-450-3100
Fax Number : 210-450-2219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 05/07/2018

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