Individual
CHRISTIAN A MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8401 DATAPOINT DR STE 104, SAN ANTONIO, TX 78229-5900
(210) 979-7500
(210) 314-4609
Mailing address
19141 STONE OAK PKWY STE 104, SAN ANTONIO, TX 78258-3367
(210) 268-0129
(210) 568-4064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1312942
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312942
PT LICENSE
TX
Enumeration date
12/16/2018
Last updated
06/15/2021
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