Individual provider Active NPI

Bianca Renee Mireles, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1790548865
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1136620 Issued in TX
Practice address
19284 Stone Oak Pkwy Ste 102
San Antonio, TX 78258-3474
Phone
(210) 268-0120
Fax
(210) 268-0170
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1136620 TX Primary

Addresses

Primary practice location

19284 Stone Oak Pkwy Ste 102
San Antonio, TX 78258-3474

Mailing address

19284 Stone Oak Pkwy Ste 102
San Antonio, TX 78258-3474
Phone (210) 268-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216000423 TX Practitioner - Nurse Practitioner 4789110602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Pain Partners PLLCGroup PAC ID 3274061783, 23 clinicians

Practice addresses (Care Compare)

3202 Cherry Ridge Dr
Suite 103
San Antonio, TX 78230-4830
Phone (210) 441-4333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1136620TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Institute of Gastroenterology Associates , PA CurrentSince Dec 2, 2024 Accepting new patients
Joycelyn M. Theard M.D,P.a. Past Accepting new patients

Locations

580 Cibolo Valley Dr
Ste 249
Cibolo, TX 78108
Phone (210) 268-0120

19284 Stone Oak Pkwy
Ste 102
San Antonio, TX 78258
Phone (210) 268-0124

19284 Stone Oak Pkwy
Ste 104
San Antonio, TX 78258
Phone (210) 268-0120

Interoperability endpoints

  • Direct secure messaging: bianca.mireles.1@29421.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1790548865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19284 STONE OAK PKWY STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583474",
            "telephone_number": "210-268-0120",
            "fax_number": "210-268-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19284 STONE OAK PKWY STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583474",
            "telephone_number": "210-268-0120",
            "fax_number": "210-268-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES",
        "first_name": "BIANCA",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1136620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.