MEDICARE: MS. LETICIA MILLER RT,R

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	2471C3402X	Radiography Radiologic Technologist	237069	CO
2	2471C3402X	Radiography Radiologic Technologist	497258	NY
3	2471C3402X	Radiography Radiologic Technologist	29054	TX
4	2471C3402X	Radiography Radiologic Technologist	641426	NJ
5	2471C3402X	Radiography Radiologic Technologist	RAD01553	RI
6	2471C3402X	Radiography Radiologic Technologist	R8854166	OH
7	2471C3402X	Radiography Radiologic Technologist	RHT85606	CA
8	2471C3402X	Radiography Radiologic Technologist	11685	MA

General Provider Information

NPI Number	:	1508983859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LETICIA MILLER RT,R

Provider Business Mailing Address
First Line	:	11331 WHISPER FALLS ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-3539
Country	:	US
Telephone Number	:	210-332-3936
Fax Number	:

Provider Business Practice Location Address
First Line	:	11331 WHISPER FALLS ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-3539
Country	:	US
Telephone Number	:	210-332-3936
Fax Number	:

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

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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