Provider Demographics
NPI:1740457456
Name:MILLER, MOLLIE ELIZABETH (LM, LMT)
Entity type:Individual
Prefix:MS
First Name:MOLLIE
Middle Name:ELIZABETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:LM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9036 N MONTERREY DR
Mailing Address - Street 2:
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009-4531
Mailing Address - Country:US
Mailing Address - Phone:817-658-5064
Mailing Address - Fax:888-876-1933
Practice Address - Street 1:9036 N MONTERREY DR
Practice Address - Street 2:
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009-4531
Practice Address - Country:US
Practice Address - Phone:817-658-5064
Practice Address - Fax:888-876-1933
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00007176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife