Provider Demographics
NPI:1073593430
Name:MILLER, LAURA SANDERS (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:SANDERS
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 STECK AVE STE A121
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8786
Mailing Address - Country:US
Mailing Address - Phone:512-328-0555
Mailing Address - Fax:512-340-0009
Practice Address - Street 1:3921 STECK AVE STE A121
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8786
Practice Address - Country:US
Practice Address - Phone:512-328-0555
Practice Address - Fax:512-340-0009
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5146TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0195224-01Medicaid
TXU56995Medicare UPIN
TX00E82TMedicare ID - Type Unspecified