Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D8355 | TX |
NPI | 1164496907 |
---|---|
Provider Name | Dr. William W Miller |
First Address | Dallas, TX 75284-6098 |
Second Address | Tyler, TX 75701-4464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 08/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132078002 | (05) | TX |
132078008 | (05) | TX |
752616977007 | TRICARE (01) | TX |
75-2616977-136 | TRICARE (01) | TX |
D66993 | (02) |