Individual
MIRANDA LYNN ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
13082 CENTERFIELD DRIVE, SUITE 200, HOUSTON, TX 77070
(281) 737-0999
Mailing address
7700 WILLOW CHASE BLVD APT 1033, HOUSTON, TX 77070-6806
(248) 660-4598
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8216
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9101003777
BLUE CROSS BLUE SHEILD
MI
Enumeration date
05/14/2021
Last updated
05/14/2021
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