Individual
SHANE MICHAEL MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5700 DALLAS PKWY, FRISCO, TX 75034-9580
(469) 515-7100
(214) 443-7309
Mailing address
2222 WELBORN ST, DALLAS, TX 75219-3924
(214) 559-5000
(214) 443-7309
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
46860
CO
2080S0010X
Pediatric Sports Medicine Physician
Primary
N2663
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209257901
—
TX
Enumeration date
04/28/2008
Last updated
02/01/2019
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