Basic Information
| Provider Information | |||||||||
| NPI: | 1295407864 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | LAURA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6817 CEDAR CREEK RD | ||||||||
| Address2: | |||||||||
| City: | TEMPLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765046131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2085301240 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3210 E CENTRAL TEXAS EXPY STE 403 | ||||||||
| Address2: | |||||||||
| City: | KILLEEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765437378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542459362 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2021 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 70502 | TX | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 80802 | TX | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.