MEDICARE: MIRANDA NUNEZ PA

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	363A00000X	Physician Assistant	PA20178	TX

General Provider Information

NPI Number	:	1265125843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRANDA NUNEZ PA

Provider Business Mailing Address
First Line	:	704 PAREDES LINE RD
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-7930
Country	:	US
Telephone Number	:	956-831-7111
Fax Number	:	956-831-7119

Provider Business Practice Location Address
First Line	:	704 PAREDES LINE RD
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-7930
Country	:	US
Telephone Number	:	956-831-7111
Fax Number	:	956-831-7119

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

Provider Enumeration Date	:	05/31/2023
Last Update Date	:	04/07/2026

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