Provider Demographics
NPI:1194026468
Name:C. ANNE MILLER O.D., P.C.
Entity Type:Organization
Organization Name:C. ANNE MILLER O.D., P.C.
Other - Org Name:MY EYE SITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C.
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-335-2077
Mailing Address - Street 1:101 SHORTHORN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7770
Mailing Address - Country:US
Mailing Address - Phone:512-507-4674
Mailing Address - Fax:
Practice Address - Street 1:13201 N FM 620
Practice Address - Street 2:SUITE 127
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-1011
Practice Address - Country:US
Practice Address - Phone:512-335-2077
Practice Address - Fax:512-335-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5943TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty