| Midtown Family Medicine | |
|
548 Waugh Dr Houston TX 77019-2002 | |
| (713) 933-0501 | |
| (713) 933-0505 |
| Full Name | Midtown Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 548 Waugh Dr, Houston, Texas |
| Authorized Official Name and Position | Rolando R Maldonado (PARTNER) |
| Authorized Official Contact | 7139330501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midtown Family Medicine 548 Waugh Dr Houston TX 77019-2002 Ph: (713) 933-0501 | Midtown Family Medicine 548 Waugh Dr Houston TX 77019-2002 Ph: (713) 933-0501 |
| NPI Number | 1831146794 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 05/04/2010 |
| Medicare PECOS PAC ID | 5991776106 |
|---|---|
| Medicare Enrollment ID | O20040803000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831146794 | NPI | - | NPPES |
| 167392302 | Medicaid | TX | |
| 167394901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rudolph M Marin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750321832 PECOS PAC ID: 5890766000 Enrollment ID: I20040804001723 |
| Provider Name | Roland R Maldonado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003856089 PECOS PAC ID: 8820069578 Enrollment ID: I20040804001763 |
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