Organization
EXECUTIVE SOLE PODIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANETRA SHARICE MIRANDA DPM (PODIATRIST)
(866) 925-5662
Entity
Organization
Contact information
Practice address
5373 W ALABAMA ST STE 204, HOUSTON, TX 77056-5923
(866) 925-5662
(866) 925-5662
Mailing address
6445 FM 1463 RD STE 160-213, KATY, TX 77494-4027
(866) 925-5662
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Enumeration date
07/21/2020
Last updated
05/06/2021
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