Provider Demographics
NPI:1538811773
Name:MILLER, TONEY GENE JR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:TONEY
Middle Name:GENE
Last Name:MILLER
Suffix:JR
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 1:13220 CHEATHAM CT
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5770
Mailing Address - Country:US
Mailing Address - Phone:405-831-8805
Mailing Address - Fax:
Practice Address - Street 1:13220 CHEATHAM CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5770
Practice Address - Country:US
Practice Address - Phone:405-831-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist