Individual
STEPHEN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. P.A.
Contact information
Practice address
8431 FREDERICKSBURG RD, SUITE 100, SAN ANTONIO, TX 78229-3364
(210) 615-7171
(210) 615-6793
Mailing address
8431 FREDERICKSBURG RD, SUITE 100, SAN ANTONIO, TX 78229-3364
(210) 615-7171
(210) 615-6793
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J7586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073584421
NPI-GROUP
TX
05
—
162478501
—
TX
01
—
1760454060
NPI
TX
01
—
8X5050
BCBS OF TEXAS
TX
01
—
DG9652
RR MEDICARE PTAN GROUP
TX
01
—
J7586
LICENSE
TX
01
—
P00024699
RAILROAD MEDICARE ID#
TX
Enumeration date
02/02/2006
Last updated
10/27/2009
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