Basic Information
Provider Information
NPI: 1023571981
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAING
FirstName: MIRANDA
MiddleName: LYNN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1941 EAST RD STE 3236
Address2:  
City: HOUSTON
State: TX
PostalCode: 770546010
CountryCode: US
TelephoneNumber: 7134862570
FaxNumber: 7134862565
Practice Location
Address1: 1941 EAST RD STE 3236
Address2:  
City: HOUSTON
State: TX
PostalCode: 770546010
CountryCode: US
TelephoneNumber: 7134862570
FaxNumber: 7134862565
Other Information
ProviderEnumerationDate: 04/08/2019
LastUpdateDate: 10/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084P0800XU0445TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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