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Individual

MICHAEL MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
Q1456
TX
390200000X
Student in an Organized Health Care Education/Training Program
57.018407
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
343132201
TX
01
8ER340
BCBS
TX
Enumeration date
10/25/2010
Last updated
03/18/2022
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