Provider Demographics
NPI:1902040827
Name:MILLER, BRANDON ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ANDREW
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 1:6431 FANNIN STREET
Mailing Address - Street 2:MSB 5.248
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-7365
Mailing Address - Fax:713-500-7296
Practice Address - Street 1:6410 FANNIN ST STE 950
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5204
Practice Address - Country:US
Practice Address - Phone:832-325-7242
Practice Address - Fax:713-512-2221
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY50426207T00000X
KYTP763207T00000X
390200000X
TXT1151207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100480880Medicaid
TX425643003Medicaid
TX425643004OtherCSHCN