Provider Demographics
NPI:1881681252
Name:MILLER, CHARLES ERNEST (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ERNEST
Last Name:MILLER
Suffix:
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 1:24275 KATY FWY STE 400
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7267
Mailing Address - Country:US
Mailing Address - Phone:346-387-7171
Mailing Address - Fax:
Practice Address - Street 1:24275 KATY FWY STE 400
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:346-387-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8285207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0012NFOtherBCBS
TX124586206Medicaid
TX1881681252OtherNPI
TXP00387032OtherMEDICARE RAILROAD
TXP00784263OtherMEDICARE RAILROAD
TX8J1929Medicare PIN
TXP00784263OtherMEDICARE RAILROAD
TXE99845Medicare UPIN
TX124586206Medicaid