Individual
CARLOS MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
E2295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020001373
RR MEDICARE
—
05
—
123715805
—
TX
01
—
8U9610
BCBS & HMO OF TX
TX
05
—
X2538
—
NM
Enumeration date
04/28/2006
Last updated
05/21/2012
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