Meenu Mireles, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01878 Issued in TX

Practice address

3051 Garden Ave
Suite 159 BLDG 1279
Fort Sam Houston, TX 78234-7598

Phone

(210) 295-4843

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1851380869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 GARDEN AVE",
            "address_2": "SUITE 159 BLDG 1279",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347598",
            "telephone_number": "210-295-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES",
        "first_name": "MEENU",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey L Mills
• Tangela Rochelle Mills, LCSW
• Thomas Keenan Millstead, D.D.S.
• Estela Samonte Miranda, MD
• Mae Hsing Miranda, PT, DPT, OCS
• Patrick James Mitchell, DPT, PT, OCS
• Thomas Mitchell, M.D.
• Michael Moak, D.O.
• Donald Michael Moe, M.D.
• Naomie Marie Moe, CRNA

• Medical Physician Assistant in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.