Provider Demographics
NPI:1235390253
Name:MILLER, BART
Entity Type:Individual
Prefix:
First Name:BART
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SPENCER HWY
Mailing Address - Street 2:STE F
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1250
Mailing Address - Country:US
Mailing Address - Phone:713-943-8573
Mailing Address - Fax:
Practice Address - Street 1:3800 SPENCER HWY
Practice Address - Street 2:STE F
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1250
Practice Address - Country:US
Practice Address - Phone:713-943-8573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist