Provider Demographics
NPI:1871513812
Name:MILLER, ORSON A (DPT)
Entity type:Individual
Prefix:
First Name:ORSON
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7149 WESTERN SKIES DR APT D
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4389
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4650 WOODROW BEAN TRANSMOUNTAIN DR
Practice Address - Street 2:SUITE G
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4424
Practice Address - Country:US
Practice Address - Phone:915-755-0738
Practice Address - Fax:915-755-6941
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX173476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist