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Organization

DRAGON FAMILY MEDICINE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN C MILLER (ADMIN ASST)
(512) 225-6345
Entity
Organization

Contact information

Practice address
2000 SOUTH IH 35, #E1, ROUND ROCK, TX 78681
(512) 244-1978
(512) 244-0787
Mailing address
2000 SOUTH IH 35, #E1, ROUND ROCK, TX 78681
(512) 225-6345
(512) 692-5205

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6637

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002EV
BCBS
05
141571301
TX
Enumeration date
11/21/2006
Last updated
01/31/2013
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