| John David Miller, MD | |
|
1615 Hospital Parkway, Suite 306, Bedford, TX 76022 | |
| (817) 684-5106 | |
| (817) 684-5120 |
| Full Name | John David Miller |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 1615 Hospital Parkway, Bedford, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831250711 | NPI | - | NPPES |
| 084655201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | D7189 (Texas) | Primary |
| Entity Name | Epiphany Dermatology Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043615263 PECOS PAC ID: 3971827791 Enrollment ID: O20150126001498 |
| Mailing Address | Practice Location Address |
|---|---|
| John David Miller, MD 1615 Hospital Parkway, Suite 306, Bedford, TX 76022 Ph: (817) 684-5106 | John David Miller, MD 1615 Hospital Parkway, Suite 306, Bedford, TX 76022 Ph: (817) 684-5106 |
Shaun Daniel Cooper, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1600 Central Dr Ste 158, Bedford, TX 76022 Phone: 817-736-2912 Fax: 817-736-2912 | |
George C Baker, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 1615 Hospital Parkway, Suite 306, Bedford, TX 76022 Phone: 817-684-5106 Fax: 817-684-5120 | |
Calvin Lamont Williams, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1600 Central Drive, Ste 158, Bedford, TX 76022 Phone: 817-736-2912 Fax: 817-736-2912 | |
Dr. Jorge Roman, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Pkwy Ste 306, Bedford, TX 76022 Phone: 817-684-5100 Fax: 817-259-2754 | |
Dr. Samantha Monique Black, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Pkwy Ste 306, Bedford, TX 76022 Phone: 817-684-5100 Fax: 817-684-5101 | |
Dr. Christopher Kenton Fuller, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1615 Hospital Pkwy Ste 306, Bedford, TX 76022 Phone: 817-684-5100 Fax: 817-684-5101 |