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General NPI Number Information
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NPI Number | 1689437568
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Entity Type | Organization
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Legal Business Name | THE MIRELES CLINIC, LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 1852 TRAWOOD DR STE E
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City | EL PASO
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State | TX
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Zip | 79935-3106
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Country | US
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Telephone | 915-257-0899
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Fax | 915-257-6294
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Provider Business Mailing Address
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Address Line | 6825 PINO REAL DR
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City | EL PASO
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State | TX
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Zip | 79912-2803
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Country | US
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Telephone | 915-257-0899
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Fax | 915-257-6294
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Authorized Official
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Title or Position | CEO
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Name | MARGARITA ROMERO
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Credential | BCBA, LBA
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Telephone | 915-257-0899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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