Provider Demographics
NPI:1225482284
Name:MILLER, RODNEY GENE (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:GENE
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3862 TEXAS HIGHWAY 77 E
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-8060
Mailing Address - Country:US
Mailing Address - Phone:903-293-6517
Mailing Address - Fax:
Practice Address - Street 1:3862 TEXAS HIGHWAY 77 E
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-8060
Practice Address - Country:US
Practice Address - Phone:903-293-6517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist