Individual
NICOLE MARIE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7501 FANNIN, STE 703, HOUSTON, TX 77054
(713) 790-4830
(713) 793-7824
Mailing address
PO BOX 3567, HOUSTON, TX 77253-3567
(713) 790-5227
(713) 790-5505
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04622
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201957201
—
TX
01
—
8N9222
BCBS TX
TX
Enumeration date
01/18/2006
Last updated
07/24/2009
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