Provider Demographics
NPI:1205809274
Name:MILLER, STEVEN RICK (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RICK
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 FOREST LN # 515057
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 JOSEY LN
Practice Address - Street 2:#200B
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2994
Practice Address - Country:US
Practice Address - Phone:972-242-0660
Practice Address - Fax:972-242-7596
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0562213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX886222OtherBC/BS
TX86101YOtherBCBS
TX0887570001Medicare NSC
TX886222OtherBC/BS
TX86101YOtherBCBS