MEDICARE: DR. DAVID RANDALL MILLER DC

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	7034	TX

General Provider Information

NPI Number	:	1376550160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RANDALL MILLER DC

Provider Business Mailing Address
First Line	:	4881 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3627
Country	:	US
Telephone Number	:	210-341-3434
Fax Number	:	210-341-4303

Provider Business Practice Location Address
First Line	:	4881 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3627
Country	:	US
Telephone Number	:	210-341-3434
Fax Number	:	210-341-4303

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/08/2007

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