Provider Demographics
NPI:1962958884
Name:MILLER, HAROLD DEAN (MS, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:DEAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25290
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77265
Mailing Address - Country:US
Mailing Address - Phone:925-238-6141
Mailing Address - Fax:
Practice Address - Street 1:4218 CHILDRESS ST
Practice Address - Street 2:UNIT B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1014
Practice Address - Country:US
Practice Address - Phone:925-238-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT47352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer