Provider Demographics
NPI:1174576243
Name:RAMIREZ, MIRANDA OLER (MD)
Entity type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:OLER
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3608 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8650
Mailing Address - Country:US
Mailing Address - Phone:972-312-0440
Mailing Address - Fax:469-467-9343
Practice Address - Street 1:3608 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8655
Practice Address - Country:US
Practice Address - Phone:972-312-0440
Practice Address - Fax:469-467-9343
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2106208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G57286Medicare UPIN