NPIMap

Organization Active NPI

John David Miller, M.D.P.a.

Doing business as Mid-Cities Dermatology Clinic

  • Specialist
  • Bedford, TX
National Provider Identifier
1467581439
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D7189 Issued in TX
Legal business name
JOHN DAVID MILLER, M.D.P.A.
Doing business as
Mid-Cities Dermatology Clinic
Practice address
1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5934
Phone
(817) 684-5106
Fax
(817) 684-5120
NPI assigned
Mar 5, 2007
Last updated
Dec 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Dr. John David Miller, M.D.NPI 1831250711
Title
Owner
Phone
(817) 684-5106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D7189 TX Primary

Addresses

Primary practice location

1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5934

Mailing address

1615 Hospital Pkwy
Suite 306
Bedford, TX 76022-5934
Phone (817) 684-5106

Other identifiers 1

IdentifierTypeStateIssuer
0846552-01MedicaidTX

Other names 1

  • Mid-Cities Dermatology Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1467581439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY",
            "address_2": "SUITE 306",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225934",
            "telephone_number": "817-684-5106",
            "fax_number": "817-684-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PKWY",
            "address_2": "SUITE 306",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760225934",
            "telephone_number": "817-684-5106",
            "fax_number": "817-684-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN DAVID MILLER, M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-684-5106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "D7189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0846552-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Cities Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bedford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.