Miranda, Roberto

Miranda, Roberto is an sole proprietor health care provider with primary practice located at 1508 Dessau Ridge Ln Apt 602 Ste B, Austin TX 78754-2121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Miranda, Roberto can be contacted via phone (512) 477-9202.

Contact Information

Primary practice address
1508 Dessau Ridge Ln Apt 602 Ste B Austin TX 78754-2121
Phone: (512) 477-9202
Fax: (512) 472-9473
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E2740 Texas

Profile Details

NPI number 1891798633
LBN Legal business name Miranda, Roberto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2005
Last updated Jan 11th, 2011 - about 13 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 1891798633 NPPES
Texas Other 00318Q BCBS
Texas MEDICAID 140282837 BCBS

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