Provider Demographics
NPI:1558340489
Name:MILLER, STEPHEN EDWARD (AUD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWARD
Last Name:MILLER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 LA SIERRA DR
Mailing Address - Street 2:STE 230
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4139
Mailing Address - Country:US
Mailing Address - Phone:214-696-9955
Mailing Address - Fax:214-696-9956
Practice Address - Street 1:5445 LA SIERRA DR
Practice Address - Street 2:STE 230
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4139
Practice Address - Country:US
Practice Address - Phone:214-696-9955
Practice Address - Fax:214-696-9956
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50305231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4500001OtherUNITED HEALTHCARE
514097OtherBCBS
4500001OtherUNITED HEALTHCARE