Individual
DOUGLAS A MIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 PEASE ST, HARLINGEN, TX 78550-8307
(956) 389-1100
Mailing address
2606 ROGERS FRK, SAN ANTONIO, TX 78258-4607
(210) 878-5569
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C55752
CA
207P00000X
Emergency Medicine Physician
Primary
M1936
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176289001
—
TX
05
—
176289002
—
TX
01
—
8N8137
BCBS
TX
Enumeration date
10/03/2005
Last updated
05/26/2015
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