Provider Demographics
NPI:1457182693
Name:MIRANDA, GINNIE PAULA-MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:GINNIE
Middle Name:PAULA-MARIE
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 S SONCY RD STE 137
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6406
Mailing Address - Country:US
Mailing Address - Phone:806-803-9165
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD STE 137
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6406
Practice Address - Country:US
Practice Address - Phone:806-803-9165
Practice Address - Fax:806-331-6085
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist