Provider Demographics
NPI:1063850139
Name:MILLER, EMILY MICHELLE (RD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 S COOPER ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5817
Mailing Address - Country:US
Mailing Address - Phone:817-466-9100
Mailing Address - Fax:817-466-9410
Practice Address - Street 1:6507 S COOPER ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5817
Practice Address - Country:US
Practice Address - Phone:817-466-9100
Practice Address - Fax:817-466-9410
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82703133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered