Provider Demographics
NPI:1508859802
Name:MILLER, JONNA C (MD)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:C
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 1:7400 FANNIN
Mailing Address - Street 2:#1050
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1923
Mailing Address - Country:US
Mailing Address - Phone:713-765-1004
Mailing Address - Fax:713-796-9485
Practice Address - Street 1:7400 FANNIN
Practice Address - Street 2:#1050
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1923
Practice Address - Country:US
Practice Address - Phone:713-765-1004
Practice Address - Fax:713-796-9485
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7187207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F23067OtherMEDICARE PIN (ANGLETON & PEARLAND)
TX8F22633Medicare PIN
TX8F23067OtherMEDICARE PIN (ANGLETON & PEARLAND)