Individual
GWENDOLYN MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
313 E 12TH ST, SUITE 101, AUSTIN, TX 78701-1954
(512) 324-9650
Mailing address
4616 W HOWARD LN, AUSTIN, TX 78728-6300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H6438
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
H6438
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118053107
—
TX
Enumeration date
06/23/2006
Last updated
10/06/2015
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