Provider Demographics
NPI:1265768568
Name:MILLER, ELAINE KAY (DO)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:KAY
Last Name:MILLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1841 MARTIN DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086
Mailing Address - Country:US
Mailing Address - Phone:817-609-4114
Mailing Address - Fax:817-609-4116
Practice Address - Street 1:1841 MARTIN DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086
Practice Address - Country:US
Practice Address - Phone:817-609-4114
Practice Address - Fax:817-609-4116
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2024-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL7812207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology