| Miracle Medical Management Inc. | |
|
20127 Ivory Valley Ln Cypress TX 77433-0030 | |
| (832) 812-9598 | |
| Not Available |
| Full Name | Miracle Medical Management Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 20127 Ivory Valley Ln, Cypress, Texas |
| Authorized Official Name and Position | Barbara Yadira Ortiz Gonzalez (CEO) |
| Authorized Official Contact | 8328129598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Medical Management Inc. 20127 Ivory Valley Ln Cypress TX 77433-0030 Ph: (832) 812-9598 | Miracle Medical Management Inc. 20127 Ivory Valley Ln Cypress TX 77433-0030 Ph: (832) 812-9598 |
| NPI Number | 1578148078 |
|---|---|
| Provider Enumeration Date | 03/16/2021 |
| Last Update Date | 06/07/2021 |
| Medicare PECOS PAC ID | 2860891553 |
|---|---|
| Medicare Enrollment ID | O20210601000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578148078 | NPI | - | NPPES |
| Provider Name | Barbara Ortiz Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962025866 PECOS PAC ID: 9638408693 Enrollment ID: I20210610000033 |
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