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Mr. Ivan Miranda, PA-C
Medical Physician Assistant in Addison, Texas
NPI 1003547670

Ivan Miranda is a Medical Physician Assistant based in Addison, TX and is specialized in Medical. Ivan Miranda practices in Addison, TX and has the professional credentials of PA-C. The NPI Number for Ivan Miranda is 1003547670 and holds a License No. PA17718 (Texas).

The current practice location address for Ivan Miranda is 16479 Dallas Pkwy Ste 320, Addison, TX and can be reached out via phone at 469-484-4260.

Location: 16479 Dallas Pkwy Ste 320, Addison, TX, 75001-6709
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003547670
Provider Name
Ivan Miranda
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
16479 Dallas Pkwy Ste 320, Addison, TX, 75001-6709
Phone Number
469-484-4260
Fax Number
Provider Enumeration Date
06/23/2022
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
16479 Dallas Pkwy Ste 320
City
Addison
State
Texas
Zip
75001-6709
Phone Number
469-484-4260
Fax Number
person
Provider Business Mailing Address Details
Address
16479 Dallas Pkwy Ste 320
City
Addison
State
Texas
Zip
75001-6709
Phone Number
469-484-4260
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA17718 (Texas)
Definition
Definition to come...
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