Provider Demographics
NPI:1053736967
Name:MILLEY, SCOTT (PTA)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MILLEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9707 ANDERSON MILL RD STE 340
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-0018
Mailing Address - Country:US
Mailing Address - Phone:512-258-5300
Mailing Address - Fax:512-258-4475
Practice Address - Street 1:9707 ANDERSON MILL RD STE 340
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-0018
Practice Address - Country:US
Practice Address - Phone:512-258-5300
Practice Address - Fax:512-258-4475
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX2061193225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant