Individual
DIANE MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2117 CENTRAL DR STE 104, BEDFORD, TX 76021-5883
(817) 283-2100
Mailing address
4324 STORM CREEK LN, BURLESON, TX 76028-7968
(817) 229-1704
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1070647
TX
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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