MEDICARE: BRENO LOUREIRO MIGUEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	L5466	TX
2	207V00000X	Obstetrics & Gynecology Physician	L5466	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043249717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENO LOUREIRO MIGUEL MD

Provider Business Mailing Address
First Line	:	6031 AIRLINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-4209
Country	:	US
Telephone Number	:	713-694-6600
Fax Number	:	713-694-6616

Provider Business Practice Location Address
First Line	:	6031 AIRLINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-4209
Country	:	US
Telephone Number	:	713-694-6600
Fax Number	:	713-694-6616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	01/14/2021

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Directions to “ BRENO LOUREIRO MIGUEL MD” Practice Location

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