Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | M1241 | TX |
NPI | 1114121662 |
---|---|
Provider Name | Darryl Chuan-Jen Miao |
First Address | Richardson, TX 75082-3542 |
Second Address | Fort Worth, TX 76104-2122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 21/05/2013 |