Individual
GLENN R MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7101 S STAPLES ST STE 103, CORPUS CHRISTI, TX 78413-5543
(361) 814-4055
(361) 814-1346
Mailing address
7101 S STAPLES ST STE 103, CORPUS CHRISTI, TX 78413-5543
(361) 814-4055
(361) 814-1346
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1441
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030428901
—
TX
Enumeration date
07/27/2006
Last updated
11/01/2010
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