Individual provider Active NPI

George Rufus Miner, IV, MD

  • Pediatrics Physician
  • Galveston, TX
National Provider Identifier
1336330521
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP1-0029678 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-0462
Phone
(409) 772-4194
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP1-0029678 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-0462

Mailing address

2314 16TH St
Lubbock, TX 79401-4433

Other identifiers 1

IdentifierTypeStateIssuer
4661837305OtherMYUTMB 4661837305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803001054 TX Practitioner - Pediatric Medicine 5294868808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Austin, TX 78723-3078

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (512) 324-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP1-0029678TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group Pediatrics CurrentSince Feb 1, 2014 Accepting new patients
Ascension Seton Past Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

4900 Mueller Blvd
#2
Austin, TX 78723

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1336330521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 16TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550462",
            "telephone_number": "409-772-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER, IV",
        "first_name": "GEORGE",
        "middle_name": "RUFUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0029678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 4661837305",
            "identifier": "4661837305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.