Provider Demographics
NPI:1225418429
Name:MILLER, ARTHUR E III (CST/CSFA)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:E
Last Name:MILLER
Suffix:III
Gender:M
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:TRAE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CST/CSFA
Mailing Address - Street 1:6401 EASTRIDGE RD APT 1508
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-5239
Mailing Address - Country:US
Mailing Address - Phone:806-438-3659
Mailing Address - Fax:
Practice Address - Street 1:6401 EASTRIDGE RD APT 1508
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5239
Practice Address - Country:US
Practice Address - Phone:806-438-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant