Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC2731 | TX |
NPI | 1508863309 |
---|---|
Provider Name | Dr. Patricia Petrosky Miller |
First Address | El Paso, TX 79915-2904 |
Second Address | El Paso, TX 79915-2904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC2731 | (02) | TX |