Basic Information
| Provider Information | |||||||||
| NPI: | 1902345622 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JASON D MILLER DO PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 736 PINEHURST DR | ||||||||
| Address2: | |||||||||
| City: | RICHARDSON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750804112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146082335 | ||||||||
| FaxNumber: | 8172843425 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 MATLOCK RD | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760152911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174184239 | ||||||||
| FaxNumber: | 8172843425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2017 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7146082335 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | Q7424 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.