MEDICARE: STUART B MILLER OD PC

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	152W00000X	Optometrist	6466TG	TX

General Provider Information

NPI Number	:	1497930028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUART B MILLER OD PC

Provider Business Mailing Address
First Line	:	6134 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3802
Country	:	US
Telephone Number	:	281-499-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	6134 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3802
Country	:	US
Telephone Number	:	281-499-2020
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. RITA SHAH
Credential	:
Telephone Number	:	281-499-2020

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	07/13/2009

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