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General NPI Number Information
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NPI Number | 1376497438
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Entity Type | Organization
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Legal Business Name | TBD HEALTH ENTERPRISES OF ARKANSAS PLLC
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 5320 W SUNSET AVE STE 157B
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City | SPRINGDALE
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State | AR
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Zip | 72762-4410
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Country | US
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Telephone | 479-434-3600
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Fax | 833-992-0797
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Provider Business Mailing Address
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Address Line | 2707 MARKET TRCE
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City | FORT SMITH
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State | AR
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Zip | 72908-8694
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Country | US
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Telephone | 479-434-3600
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Fax | 833-992-0797
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS BENJAMIN DE MIRANDA
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Credential | MD
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Telephone | 479-434-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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