Provider Demographics
NPI:1881774297
Name:MILLER, HAROLD JAY (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:JAY
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN
Mailing Address - Street 2:MSB 3.286
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-500-6412
Mailing Address - Fax:713-500-7860
Practice Address - Street 1:5656 KELLEY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026
Practice Address - Country:US
Practice Address - Phone:713-566-6600
Practice Address - Fax:713-566-4418
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3062207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133223107Medicaid
TX133223107Medicaid
TX88H837Medicare PIN
TX88W269Medicare PIN
TX8L1485Medicare PIN