Provider Demographics
NPI:1508863309
Name:MILLER, PATRICIA PETROSKY (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:PETROSKY
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ELAINE
Other - Last Name:PETROSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7685 N LOOP DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-2904
Mailing Address - Country:US
Mailing Address - Phone:915-778-7791
Mailing Address - Fax:915-774-0567
Practice Address - Street 1:7685 N LOOP DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-2904
Practice Address - Country:US
Practice Address - Phone:915-778-7791
Practice Address - Fax:915-774-0567
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2731111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC2731Medicare UPIN
TX601027Medicare ID - Type Unspecified