Fred-Miranda, Iliana

Fred-Miranda, Iliana is an individual health care provider with primary practice located at 4458 Medical Dr Ste 205 , San Antonio TX 78229-3748. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Fred-Miranda, Iliana can be contacted via phone (210) 614-1515.

Contact Information

Primary practice address
4458 Medical Dr Ste 205 San Antonio TX 78229-3748
Phone: (210) 614-1515
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X J8538 Texas

Profile Details

NPI number 1851366785
LBN Legal business name Fred-Miranda, Iliana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Jan 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851366785 NPPES
Texas MEDICAID 146266501

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