Provider Demographics
NPI:1629595335
Name:MINER, CARINA CALDERON
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:CALDERON
Last Name:MINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1259 FM 1463 RD STE 500
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5480
Mailing Address - Country:US
Mailing Address - Phone:281-766-3831
Mailing Address - Fax:844-615-5271
Practice Address - Street 1:1259 FM 1463 RD STE 500
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5480
Practice Address - Country:US
Practice Address - Phone:281-766-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116266235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist