Provider Demographics
NPI:1396265286
Name:MILLER, SUSAN CHRISTINE (RPH)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CHRISTINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W MORTON ST STE 121
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1600
Mailing Address - Country:US
Mailing Address - Phone:903-463-6979
Mailing Address - Fax:903-463-6976
Practice Address - Street 1:2300 W MORTON ST STE 121
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1600
Practice Address - Country:US
Practice Address - Phone:903-463-6979
Practice Address - Fax:903-463-6976
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist