Provider Demographics
NPI:1013956291
Name:MILLER, RACHEL LEAH (PAC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEAH
Last Name:MILLER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8965
Mailing Address - Country:US
Mailing Address - Phone:512-476-9195
Mailing Address - Fax:512-476-2857
Practice Address - Street 1:3807 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8965
Practice Address - Country:US
Practice Address - Phone:512-476-9195
Practice Address - Fax:512-476-2857
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03106363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84P610Medicare ID - Type Unspecified
TXPA03106OtherPA LICENSE
TXCK3641OtherRR MEDICARE GROUP ID
TX84P610Medicare ID - Type Unspecified
TX1245417294OtherGROUP NPI
TX00486UOtherMEDICARE GROUP BILLING ID