Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | L5051 | TX |
NPI | 1194794537 |
---|---|
Provider Name | Dr. Christopher Wayne Miars |
First Address | Dallas, TX 75284-8491 |
Second Address | Waco, TX 76712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00394860 | RAILROAD UPIN (01) | TX |