Provider Demographics
NPI:1639245756
Name:MILLER, PAULA F (LCSW)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:F
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 AIRPORT AVE
Mailing Address - Street 2:BLDG D
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5759
Mailing Address - Country:US
Mailing Address - Phone:281-239-1369
Mailing Address - Fax:281-239-0828
Practice Address - Street 1:4910 AIRPORT AVE
Practice Address - Street 2:BLDG A
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5759
Practice Address - Country:US
Practice Address - Phone:281-239-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25540104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82641WMedicare ID - Type UnspecifiedTEXANA GROUP