Miller, Gwendolyn
Miller, Gwendolyn is an sole proprietor health care provider with primary practice located at 313 E 12Th St Suite 101, Austin TX 78701-1954. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Miller, Gwendolyn can be contacted via phone (512) 324-9650.Contact Information
Primary practice address
313 E 12Th St Suite 101
Austin TX 78701-1954
Phone: (512) 324-9650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | H6438 | Texas |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | H6438 | Texas |
Profile Details
| NPI number | 1700812716 |
|---|---|
| LBN Legal business name | Miller, Gwendolyn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Oct 6th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700812716 | NPPES |
| Texas | MEDICAID | 118053107 |
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