Individual
MIRAIE WARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
2425 HIGHWAY 121 STE 201, BEDFORD, TX 76021-5011
(817) 283-5166
(817) 283-5176
Mailing address
3801 WILLIAM D TATE AVE STE 105, GRAPEVINE, TX 76051-8755
(817) 488-6812
(817) 251-1303
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
S2196
TX
Other
Enumeration date
05/21/2014
Last updated
08/22/2019
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