Provider Demographics
NPI:1609133909
Name:MILLER, ANDREW LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LOUIS
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:601 OMEGA DR STE 208
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2075
Mailing Address - Country:US
Mailing Address - Phone:817-465-5881
Mailing Address - Fax:817-465-6336
Practice Address - Street 1:1201 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4215
Practice Address - Country:US
Practice Address - Phone:817-335-5288
Practice Address - Fax:817-338-0927
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0744207RC0200X, 207RP1001X
CODR.0056453207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX811085Medicaid