Individual
ANTONIO MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, RD, LD, CDCES
Contact information
Practice address
11801 SOUTH FREEWAY, FORT WORTH, TX 76115
(817) 551-2706
(817) 551-2570
Mailing address
6245 RUFE SNOW DRIVE, STE 280, UNIT 540, FORT WORTH, TX 76148
(682) 900-2624
(817) 527-6610
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85363
TX
Other
Enumeration date
04/11/2019
Last updated
04/26/2023
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