Provider Demographics
NPI:1326039819
Name:MIRELES, TERESA (MSN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:MIRELES
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 PRIMROSE AVE
Mailing Address - Street 2:STE F
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4162
Mailing Address - Country:US
Mailing Address - Phone:956-627-5320
Mailing Address - Fax:956-627-5323
Practice Address - Street 1:2208 PRIMROSE AVE STE F
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4162
Practice Address - Country:US
Practice Address - Phone:956-627-5320
Practice Address - Fax:956-627-5323
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP113850363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174458305Medicaid
TX316315YVCSMedicare PIN
TXP88736Medicare UPIN