Provider Demographics
NPI:1083926752
Name:MILLER, STANLEY H (DO)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:H
Last Name:MILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CORP MEDICAL DIRECTOR, AMERICAN AIRLINES/PREMISE HEALTH
Mailing Address - Street 2:4501 CREWMEMBER WAY, F 103 - THE CLINIC SKYVIEW 5
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76155-3203
Mailing Address - Country:US
Mailing Address - Phone:248-520-4623
Mailing Address - Fax:
Practice Address - Street 1:2301 N BRAZOSPORT BLVD # B-101
Practice Address - Street 2:DOW CHEMICAL HEALTH SERVICES
Practice Address - City:FREEPORT
Practice Address - State:TX
Practice Address - Zip Code:77541-3203
Practice Address - Country:US
Practice Address - Phone:979-238-1110
Practice Address - Fax:979-238-0479
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010103192083P0500X
TXP1200246YC3302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based