Provider Demographics
NPI:1336631241
Name:MILLER, ZACHARY POMPEI (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:POMPEI
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20821 US HIGHWAY 281 N STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7594
Mailing Address - Country:US
Mailing Address - Phone:210-610-4480
Mailing Address - Fax:210-334-0948
Practice Address - Street 1:905 N MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1699
Practice Address - Country:US
Practice Address - Phone:830-816-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1305273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1305273OtherPT LICENSE