Organization
EGBERT MIRANDA MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EGBERT MIRANDA MD (OWNER)
(361) 991-5520
Entity
Organization
Contact information
Practice address
5866 S STAPLES ST, STE. 403, CORPUS CHRISTI, TX 78413-3700
(361) 991-5520
(361) 991-5521
Mailing address
5866 S STAPLES ST, STE. 403, CORPUS CHRISTI, TX 78413-3700
(361) 991-5520
(361) 991-5521
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00F33D
BLUECROSS BLUESHIELD
TX
05
—
153788-01
—
TX
Enumeration date
10/04/2006
Last updated
10/03/2007
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