Organization
STEPHEN MILLER MD PA
Active
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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