Provider Demographics
NPI:1922734771
Name:MIGUEL-GHAZIOSHARIF, LIGIA (MSOP, CP)
Entity Type:Individual
Prefix:
First Name:LIGIA
Middle Name:
Last Name:MIGUEL-GHAZIOSHARIF
Suffix:
Gender:F
Credentials:MSOP, CP
Other - Prefix:
Other - First Name:LIGIA
Other - Middle Name:
Other - Last Name:MIGUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11011 WHISKEY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1872
Mailing Address - Country:US
Mailing Address - Phone:520-891-5833
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225000000X, 222Z00000X
TXCP004493224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist