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General NPI Number Information
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NPI Number | 1619105798
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Entity Type | Organization
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Legal Business Name | JAMIR E MIRELES MD LLC
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Dates
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Enumeration Date | 06/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 5231 NORTH FWY
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City | HOUSTON
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State | TX
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Zip | 77022-1730
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Country | US
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Telephone | 713-694-2300
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Fax | 713-694-2303
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Provider Business Mailing Address
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Address Line | 5231 NORTH FWY
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City | HOUSTON
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State | TX
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Zip | 77022-1730
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Country | US
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Telephone | 713-694-2300
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Fax | 713-694-2303
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JAMIR ENCARNACION MIRELES
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Credential | MD
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Telephone | 713-694-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M7436
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License Number State | TX
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