=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659627040
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ONCOLOGY & HEMATOLOGY OF SOUTH TEXAS PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2012
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2344 LAGUNA DEL MAR CT STE 101
-----------------------------------------------------
City | LAREDO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78041-3468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-724-8543
-----------------------------------------------------
Fax | 956-724-8352
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2344 LAGUNA DEL MAR CT STE 101
-----------------------------------------------------
City | LAREDO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78041-3468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-724-8543
-----------------------------------------------------
Fax | 956-724-8352
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. EDUARDO MIRANDA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 956-724-8543
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------