Provider Demographics
NPI:1134183122
Name:MILLER, ANDREA E (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:817-684-9970
Mailing Address - Fax:817-684-9373
Practice Address - Street 1:1604 HOSPITAL PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6986
Practice Address - Country:US
Practice Address - Phone:817-684-9970
Practice Address - Fax:817-684-9373
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5378207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098012001Medicaid
TX8K5298Medicare PIN
TX098012001Medicaid