Individual
CRYSTAL MIRELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3111 PARHAM DR APT 151, GRAND PRAIRIE, TX 75052-8226
(682) 232-5329
Mailing address
3111 PARHAM DR, GRAND PRAIRIE, TX 75052-8239
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
332701
TX
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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