Individual
DR. JOAQUIN G. MIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4383 MEDICAL DR, SAN ANTONIO, TX 78229-3307
(210) 593-5700
(210) 593-5992
Mailing address
4383 MEDICAL DR, SAN ANTONIO, TX 78229-3307
(210) 593-5700
(210) 593-5992
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
E2055
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131561602
—
TX
01
—
4080638
AETNA PIN#
—
Enumeration date
06/26/2006
Last updated
07/30/2012
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