Provider Demographics
NPI:1063139137
Name:MILES, SABRINA STARR (RD)
Entity type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:STARR
Last Name:MILES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:SABRINA
Other - Middle Name:STARR
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:700 E. MARSHALL AVENUE, SUITE 3000
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5500
Mailing Address - Country:US
Mailing Address - Phone:903-315-4400
Mailing Address - Fax:903-315-2595
Practice Address - Street 1:700 E. MARSHALL AVENUE, SUITE 3000
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5500
Practice Address - Country:US
Practice Address - Phone:903-315-4400
Practice Address - Fax:903-315-2595
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT03010133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered