Provider Demographics
NPI:1407922685
Name:MILLER, QUINTESSA (MD)
Entity Type:Individual
Prefix:DR
First Name:QUINTESSA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8815 RIVER TRCE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2376
Mailing Address - Country:US
Mailing Address - Phone:210-422-9819
Mailing Address - Fax:210-280-8988
Practice Address - Street 1:21 SPURS LN
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1669
Practice Address - Country:US
Practice Address - Phone:210-280-8988
Practice Address - Fax:210-280-8988
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025562208600000X
TXN4589208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery