Provider Demographics
NPI:1073872016
Name:ANDAYA, MIRIAM ESTRADA (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ESTRADA
Last Name:ANDAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 SOUTH U.S. HIGHWAY 59
Mailing Address - Street 2:LABETTE HEALTH
Mailing Address - City:PARSONS
Mailing Address - State:KS
Mailing Address - Zip Code:67357
Mailing Address - Country:US
Mailing Address - Phone:620-820-5374
Mailing Address - Fax:
Practice Address - Street 1:1902 SOUTH U.S. HIGHWAY 59
Practice Address - Street 2:LABETTE HEALTH
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357
Practice Address - Country:US
Practice Address - Phone:620-820-5374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04356422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology