Individual
JUSTIN A MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6431 FANNIN ST, MSB 5.020, HOUSTON, TX 77030-1501
(713) 500-6200
(713) 500-6208
Mailing address
6431 FANNIN ST, MSB 5.020, HOUSTON, TX 77030-1501
(713) 500-6200
(713) 500-6208
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
R1832
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2012
Last updated
02/26/2017
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