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Individual

LUIS A MIELES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6410 FANNIN ST, SUITE 370, HOUSTON, TX 77030-3000
(713) 704-6300
(713) 704-6360
Mailing address
6411 FANNIN ST, SUITE R7.21, HOUSTON, TX 77030-1501
(713) 704-6770
(713) 704-7041

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
L6118
TX
208600000X
Surgery Physician
L6118
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04623253
MISSISSIPPI MEDICAID
MS
01
8W5621
BCBS
TX
01
P00365834
RAIL ROAD MEDICARE
TX
Enumeration date
07/02/2006
Last updated
03/27/2008
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