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General NPI Number Information
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NPI Number | 1285523621
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Entity Type | Individual
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Provider Name | SHALOM MIRANDA
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 16835 DEER CREEK DR STE 120
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City | SPRING
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State | TX
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Zip | 77379-5803
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Country | US
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Telephone | 281-379-4373
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Fax |
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Provider Business Mailing Address
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Address Line | 22719 PETRIZZI LN
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City | KATY
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State | TX
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Zip | 77449-8737
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Country | US
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Telephone | 281-677-7447
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Fax | 281-677-7447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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