Provider Demographics
NPI:1548464795
Name:MILLER, MARSHA R (DC)
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 S BUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8605
Mailing Address - Country:US
Mailing Address - Phone:214-275-4124
Mailing Address - Fax:241-275-4408
Practice Address - Street 1:2306 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8605
Practice Address - Country:US
Practice Address - Phone:214-275-4124
Practice Address - Fax:241-275-4408
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3065OtherBCBSTX