Provider Information for 1508369182
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LORI MIRELES
Sex: Female
NPI: 1508369182
Last Updated: 2023-09-28
Certification Date: 2023-09-28
Certification Date: 2023-09-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508369182 | ||||||||
| Enumeration Date | 2018-03-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1901 S 24TH AVE EDINBURG, TX 78539-6533 United States Phone: 956-289-7000 | Fax:956-289-7257 | ||||||||
| Primary Practice Address | 2215 W BUSINESS 83 WESLACO, TX 78596-1100 United States Phone: 956-520-8800 | Fax:956-289-7257 | ||||||||
| Secondary Practice Address(es) | 1901 S 24TH AVE | ||||||||
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