Provider Demographics
NPI:1922652080
Name:PFISTER, MIRAFLOR G (PT)
Entity Type:Individual
Prefix:
First Name:MIRAFLOR
Middle Name:G
Last Name:PFISTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:MAYA
Other - Middle Name:G
Other - Last Name:PFISTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:3605 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-5204
Mailing Address - Country:US
Mailing Address - Phone:214-476-2307
Mailing Address - Fax:
Practice Address - Street 1:8383 MEADOW RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3701
Practice Address - Country:US
Practice Address - Phone:214-239-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-27
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1068070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty