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Individual
LAURA P MIRELES
Active
Individual
LAURA P MIRELES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1119812
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1119812
NCCPA-NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
TX
05
—
343316102
—
TX
Enumeration date
09/30/2014
Last updated
02/19/2018
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