Provider Demographics
NPI:1750260659
Name:MIRELES-MONTOYA, ALEC N
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:N
Last Name:MIRELES-MONTOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8565
Mailing Address - Country:US
Mailing Address - Phone:214-415-6514
Mailing Address - Fax:
Practice Address - Street 1:9550 SKILLMAN ST STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8250
Practice Address - Country:US
Practice Address - Phone:972-327-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor