Provider Demographics
NPI:1477080695
Name:MILLER, JACOB M (DPT)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:M
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:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-0176
Mailing Address - Country:US
Mailing Address - Phone:682-999-8766
Mailing Address - Fax:682-444-7265
Practice Address - Street 1:9412 ED ROBSON BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207
Practice Address - Country:US
Practice Address - Phone:682-999-8766
Practice Address - Fax:682-444-7265
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-18
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1291448225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist