Organization Active NPI

Monte C Miller PSYD

  • Adult Development & Aging Psychologist
  • San Antonio, TX
National Provider Identifier
1497952949
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
License
25472 Issued in TX
Legal business name
MONTE C MILLER PSYD
Practice address
24165 Ih-10 W
Ste 217-475
San Antonio, TX 78257-1159
Phone
(210) 892-2333
Fax
(855) 532-9272
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Authorized official

Name
Dr. Monte Miller, PSYD
Title
Clinical Director
Phone
(210) 219-6151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TA0700X 25472 TX Primary

Addresses

Primary practice location

24165 Ih-10 W
Ste 217-475
San Antonio, TX 78257-1159

Mailing address

24165 Ih-10 W
Ste 217-475
San Antonio, TX 78257-1159
Phone (210) 892-2333

Other identifiers 1

IdentifierTypeStateIssuer
079562701MedicaidTX

National Provider Directory

National Provider Directory

Locations

1102 River Rd
Fair Oaks Ranch, TX 78006
Phone (830) 249-2799

24165 W Interstate 10
Ste 217475
San Antonio, TX 78257
Phone (830) 885-5703

5430 Fredericksburg Rd
Ste 618
San Antonio, TX 78229
Phone (210) 524-9402

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356652800000",
    "number": "1497952949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 IH-10 W",
            "address_2": "STE 217-475",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "210-892-2333",
            "fax_number": "855-532-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 IH-10 W",
            "address_2": "STE 217-475",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "210-892-2333",
            "fax_number": "855-532-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE C MILLER PSYD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-12-28",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "210-219-6151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "TX",
            "license": "25472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079562701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.