MEDICARE: DR. PAUL GERARD MILLER D.C.

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
1	111N00000X	Chiropractor	12713	TX

General Provider Information

NPI Number	:	1134528938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL GERARD MILLER D.C.

Provider Business Mailing Address
First Line	:	9238 N LOOP 1604 W
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2577
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9238 N LOOP 1604 W
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2577
Country	:	US
Telephone Number	:	210-251-3514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2014
Last Update Date	:	10/30/2015

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