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Organization

CARLOS MIRANDA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLOS MIRANDA MD (PRESIDENT)
(915) 351-6600
Entity
Organization

Contact information

Practice address
5849 DIAMOND POINT CIR, EL PASO, TX 79912-4156
(915) 351-6600
(915) 351-6601
Mailing address
4849 N MESA ST, SUITE 201, EL PASO, TX 79912-5916
(915) 351-6600
(915) 351-6601

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0022NH
BCBS
TX
05
179704501
TX
Enumeration date
07/27/2006
Last updated
05/21/2012
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