Provider Demographics
NPI:1184700254
Name:MILLER, CHARLES BROCK (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BROCK
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8435 WURZBACH RD STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3374
Mailing Address - Country:US
Mailing Address - Phone:210-450-9800
Mailing Address - Fax:210-450-4967
Practice Address - Street 1:8435 WURZBACH RD STE 305
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3374
Practice Address - Country:US
Practice Address - Phone:210-450-9800
Practice Address - Fax:210-450-4967
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU5168207RG0100X, 207R00000X
NC2007-00694207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine