Individual
JOHN R MIREUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12554 RIATA VISTA CIRCLE, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIRCLE, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
J8677
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124684503
—
TX
05
—
124684512
—
TX
01
—
J8677
STATE LICENSE
TX
Enumeration date
06/14/2006
Last updated
05/02/2016
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