MEDICARE: MAXIMILIAN MULDER CORROCHANO 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	2084A2900X	Neurocritical Care Physician	44914	OK
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	S5442	TX
3	207R00000X	Internal Medicine Physician	44914	OK
4	207R00000X	Internal Medicine Physician	S5442	TX
5	2084A2900X	Neurocritical Care Physician	S5442	TX
6	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	44914	OK
7	2084N0400X	Neurology Physician	S5442	TX
8	207R00000X	Internal Medicine Physician	20361	MN
9	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	57844	MN

General Provider Information

NPI Number	:	1982882262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXIMILIAN MULDER CORROCHANO M.D.

Provider Business Mailing Address
First Line	:	5605 N MACARTHUR BLVD STE 740
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2626
Country	:	US
Telephone Number	:	214-960-5681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 N BECKLEY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1201
Country	:	US
Telephone Number	:	214-947-8181
Fax Number	:

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

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	06/09/2026

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