Provider Demographics
NPI:1841931359
Name:MILLER, DANIEL BRYAN (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRYAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 KASE ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-2303
Mailing Address - Country:US
Mailing Address - Phone:580-799-0368
Mailing Address - Fax:
Practice Address - Street 1:6301 NW QUANNAH PARKER TRL
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-1326
Practice Address - Country:US
Practice Address - Phone:580-510-0357
Practice Address - Fax:580-510-0049
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist