Organization
STEPHEN MILLER MD PA
Active
Other names
Dermatology San Antonio
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MILLER MD (AUTHORIZED OFFICIAL)
(210) 615-7171
Entity
Organization
Contact information
Practice address
16110 VIA SHAVANO, SAN ANTONIO, TX 78249-2380
(210) 615-7171
(210) 615-6793
Mailing address
16110 VIA SHAVANO, SAN ANTONIO, TX 78249-2380
(210) 615-7171
(210) 615-6793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J7586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073584421
NPI
TX
01
—
8X5050
BCBS
TX
01
—
DG9652
RR MEDICARE PTAN GROUP
TX
01
—
J7586
STATE LICENSE
TX
01
—
P00024699
RR MEDICARE PTAN
TX
Enumeration date
02/01/2006
Last updated
10/09/2023
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