Provider Demographics
NPI:1497954903
Name:MILLER, BOBBY (LCSW)
Entity Type:Individual
Prefix:
First Name:BOBBY
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 HILLCROFT ST STE 312
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3104
Mailing Address - Country:US
Mailing Address - Phone:713-298-7786
Mailing Address - Fax:713-988-8293
Practice Address - Street 1:6440 HILLCROFT ST STE 312
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3104
Practice Address - Country:US
Practice Address - Phone:713-298-7786
Practice Address - Fax:713-988-8293
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX025831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical