LANE R MILLER MD PA
Osteopathic Medicine at Birmingham Dr, College Station, TX

License number
Texas L1673
Category
Osteopathic Medicine
Type
Cardiovascular Disease
Owner
Name: DR. LANE R MILLER MD
Title: OWNER
Phone: (979) 764-1474
Address
Address
1721 Birmingham Dr, College Station, TX 77845
National Provider ID: 1588697163
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LANE R. MILLER, M.D., PA

College Station, TX

Status:
Inactive
Industry:
Medical Doctor's Office
Registration:
Apr 20, 2005
Addresses:
1721 Birmingham Dr, College Station, TX 77845 (Mailing)
1605 Rock Pr Rd, College Station, TX 77845
State ID:
0800482568
Business type:
Professional Association
President, Treasurer, Secretary, Director, Member, Vice-President:
Lane R. Miller President, Treasurer, Secretary, Director, Member, Vice-President, inactive
Agent:
Lane Ray Miller,1721 Birmingham Rd, College Station, TX 77845 (Physical)
TIN:
32035415366

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