Provider Demographics
NPI:1538141114
Name:MIRANDA, ESTELA SAMONTE (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTELA
Middle Name:SAMONTE
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:311 CLUBHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1906
Mailing Address - Country:US
Mailing Address - Phone:210-733-6568
Mailing Address - Fax:210-680-2502
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE-QD (CREDS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-1600
Practice Address - Fax:210-916-4040
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG41712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry