Provider Demographics
NPI:1629229299
Name:MILLER, ALAN NEWTON II (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:NEWTON
Last Name:MILLER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 WEST GRAUWYLER RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2206
Mailing Address - Country:US
Mailing Address - Phone:972-254-9629
Mailing Address - Fax:
Practice Address - Street 1:1225 WEST GRAUWYLER RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2206
Practice Address - Country:US
Practice Address - Phone:972-254-9629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC-4444208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1379323OtherTPI
TX7100051063OtherMEDICAID NAIS
TXE-80338Medicare UPIN