Provider Demographics
NPI:1942484100
Name:MIRANDA-GRAJALES, HECTOR ALEJANDRO (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:ALEJANDRO
Last Name:MIRANDA-GRAJALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4201 BEE CAVES ROAD
Mailing Address - Street 2:SUITE # C-213
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-960-4717
Mailing Address - Fax:855-868-9882
Practice Address - Street 1:4201 BEE CAVES RD
Practice Address - Street 2:SUITE # C-213
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-960-4717
Practice Address - Fax:855-868-9882
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME107880208100000X, 208VP0014X
TXQ4469208100000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation