Provider Demographics
NPI:1346514999
Name:MILLER, KATHARINE LEIGH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:KATHARINE
Other - Middle Name:LEIGH
Other - Last Name:CUMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5656 BEE CAVES RD
Mailing Address - Street 2:K-200
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5280
Mailing Address - Country:US
Mailing Address - Phone:512-329-6644
Mailing Address - Fax:
Practice Address - Street 1:5656 BEE CAVES RD
Practice Address - Street 2:K-200
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5280
Practice Address - Country:US
Practice Address - Phone:512-329-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA07676OtherTX PA07676