Provider Demographics
NPI:1962631689
Name:MILLER, JANELL (PTA)
Entity Type:Individual
Prefix:
First Name:JANELL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2924
Mailing Address - Country:US
Mailing Address - Phone:956-687-4560
Mailing Address - Fax:956-618-1342
Practice Address - Street 1:201 N FM 3167
Practice Address - Street 2:UNIT E
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6724
Practice Address - Country:US
Practice Address - Phone:956-488-1999
Practice Address - Fax:956-488-1616
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2069012225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant