Provider Demographics
NPI:1639391451
Name:MIRANDA, CELIA ILIANA (AUD)
Entity Type:Individual
Prefix:DR
First Name:CELIA
Middle Name:ILIANA
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2967 OAK RUN PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-5379
Mailing Address - Country:US
Mailing Address - Phone:830-360-2000
Mailing Address - Fax:830-240-5831
Practice Address - Street 1:2967 OAK RUN PKWY STE 315
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-5379
Practice Address - Country:US
Practice Address - Phone:326-892-2204
Practice Address - Fax:432-689-2273
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51044231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX51044OtherSTATE LICENSE