Organization
JASON C MILLER DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT PENNELL (OFFICE MANAGER)
(281) 348-2166
Entity
Organization
Contact information
Practice address
350 KINGWOOD MEDICAL DR, SUITE 150, KINGWOOD, TX 77339-6405
(281) 348-2166
(281) 358-2153
Mailing address
350 KINGWOOD MEDICAL DR, SUITE 150, KINGWOOD, TX 77339-6405
(281) 348-2166
(281) 358-2153
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087
STATE LICENSE NUMBER
TX
Enumeration date
04/30/2014
Last updated
04/30/2014
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