Healthcare Provider Details

I. General information

NPI: 1902718059
Provider Name (Legal Business Name): STEPHANIE E MIRABELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 E CENTRAL TEXAS EXPY UNIT A
BELTON TX
76513-8490
US

IV. Provider business mailing address

842 HOBBY RD
COPPERAS COVE TX
76522-4460
US

V. Phone/Fax

Practice location:
  • Phone: 512-643-9344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2160789
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: