Provider Demographics
NPI:1457447880
Name:MIRELES, RUBEN ZEPEDA (RN,CCP)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:ZEPEDA
Last Name:MIRELES
Suffix:
Gender:M
Credentials:RN,CCP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:885 COUNTY ROAD 375
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253
Mailing Address - Country:US
Mailing Address - Phone:210-887-6974
Mailing Address - Fax:210-949-3311
Practice Address - Street 1:7400 MERTON MINTER BLVD.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-949-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPF0111246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular