Provider Demographics
NPI:1720141476
Name:MILLER, C. ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:C.
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 GUADALUPE RIVER LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-6004
Mailing Address - Country:US
Mailing Address - Phone:512-335-2077
Mailing Address - Fax:512-335-2811
Practice Address - Street 1:13201 RANCH ROAD 620 N
Practice Address - Street 2:STE 127
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-1011
Practice Address - Country:US
Practice Address - Phone:512-335-2077
Practice Address - Fax:512-335-2811
Is Sole Proprietor?:No
Enumeration Date:2006-12-17
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5943TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist