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Individual

DR. BRADLEY B. MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3601 4TH ST, LUBBOCK, TX 79430-8115
(806) 743-2155
(806) 743-2117
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787

Taxonomy

Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
0101239526
VA
207ZN0500X
Neuropathology Physician
N8042
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
N8042
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
192721100
FIRSTCARE
TX
05
43639208
NM
01
8CR251
BC/BS
TX
01
8CR252
HMO BLUE
TX
Enumeration date
07/24/2006
Last updated
05/08/2012
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