Individual
DR. MARKUS MILLER PROVENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2600 W STASSNEY LN, AUSTIN, TX 78745-3401
(650) 248-7274
Mailing address
136 FLATLAND TRL, SAN MARCOS, TX 78666-3296
(650) 248-7274
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
37537
TX
103TC1900X
Counseling Psychologist
Primary
37537
TX
Other
Enumeration date
04/08/2020
Last updated
10/02/2025
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