MEDICARE: MISS MARIA MONETTE SALALIMA REGALADO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	L3797	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0018MP	OTHER	TX	BLUECROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	L3797	OTHER	TX	TEXAS LICENSE #

General Provider Information

NPI Number	:	1407818149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARIA MONETTE SALALIMA REGALADO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 452088
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-0051
Country	:	US
Telephone Number	:	956-717-8600
Fax Number	:	956-725-8043

Provider Business Practice Location Address
First Line	:	10710 MCPHERSON RD STE 203
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6363
Country	:	US
Telephone Number	:	956-717-8600
Fax Number	:	956-725-8043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	11/29/2007

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