Provider Demographics
NPI:1265435663
Name:MILLER, ALEXANDER R (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:R
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 1:4383 MEDICAL DR
Mailing Address - Street 2:SUITE 4044
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3307
Mailing Address - Country:US
Mailing Address - Phone:210-593-2575
Mailing Address - Fax:210-593-5992
Practice Address - Street 1:4383 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3307
Practice Address - Country:US
Practice Address - Phone:210-593-5700
Practice Address - Fax:210-593-5992
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0938208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117936805Medicaid
TX8L23095OtherMEDICARE PTAN
TX117936804Medicaid
TXG04975Medicare UPIN
TX8A3324Medicare ID - Type Unspecified