MEDICARE: DR. MARIANO AMADOR MD

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	208000000X	Pediatrics Physician	K0603	TX
2	208000000X	Pediatrics Physician	19837	OR
3	208000000X	Pediatrics Physician	31628	WA

General Provider Information

NPI Number	:	1851317432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANO AMADOR MD

Provider Business Mailing Address
First Line	:	4646 RIVERSTONE BLVD.
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6141
Country	:	US
Telephone Number	:	281-499-1855
Fax Number	:	281-499-1585

Provider Business Practice Location Address
First Line	:	4646 RIVERSTONE BLVD.
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6141
Country	:	US
Telephone Number	:	281-499-1855
Fax Number	:	281-499-1585

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

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MARIANO AMADOR MD” Practice Location

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