Organization
KEVIN L MILLER MD, PA
Active
Organization
KEVIN L MILLER MD, PA
Active
Other names
GEORGETOWN DERMATOLOGY AND SKIN CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L MILLER MD (PRESIDENT)
(512) 819-9910
Entity
Organization
Contact information
Practice address
700 SAN GABRIEL VILLAGE BLVD, STE 105, GEORGETOWN, TX 78626-5594
(512) 819-9910
(512) 819-9970
Mailing address
700 SAN GABRIEL VILLAGE BLVD, STE 105, GEORGETOWN, TX 78626-5594
(512) 819-9910
(512) 819-9970
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
L1393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
283939
SCOTT AND WHITE
TX
01
—
7524367
AETNA
TX
01
—
DA4188
RAIL ROAD MEDICARE
TX
Enumeration date
08/05/2007
Last updated
08/23/2011
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