Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | L6118 | TX |
N | 208200000X | Surgeon | L6118 | TX |
N | 208600000X | Surgeon | L6118 | TX |
NPI | 1598794349 |
---|---|
Provider Name | Luis A Mieles |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 27/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04623253 | MISSISSIPPI MEDICAID (01) | MS |
8W5621 | BCBS (01) | TX |
E28595 | (02) | TX |
P00365834 | RAIL ROAD MEDICARE (01) | TX |