Provider Demographics
NPI:1891313870
Name:MILLER, WILLIAM ANDREW JR
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:MILLER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 COLLEGE LN
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1420
Mailing Address - Country:US
Mailing Address - Phone:832-876-9155
Mailing Address - Fax:
Practice Address - Street 1:9715 BECKWOOD POST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5077
Practice Address - Country:US
Practice Address - Phone:832-876-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility