MEDICARE: M GRAYSON MILLER LPC

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	101YP2500X	Professional Counselor	18083	TX

General Provider Information

NPI Number	:	1952371197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	M GRAYSON MILLER LPC

Provider Business Mailing Address
First Line	:	7700 SAN FELIPE STREET
Second Line	:	SUITE 350
City	:	HOUSTON
State	:	TX
Zip	:	77063-1630
Country	:	US
Telephone Number	:	713-785-1500
Fax Number	:	713-785-1512

Provider Business Practice Location Address
First Line	:	7700 SAN FELIPE ST
Second Line	:	SUITE 350
City	:	HOUSTON
State	:	TX
Zip	:	77063-1630
Country	:	US
Telephone Number	:	713-785-1500
Fax Number	:	713-785-1512

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	03/12/2012

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