Healthcare Provider Details

I. General information

NPI: 1710917794
Provider Name (Legal Business Name): ILIANA ARELLANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: N/A N/A MD

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 03/07/2023
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST # 1.240A
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

6431 FANNIN ST # 1.240A
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-6577
  • Fax: 713-500-6556
Mailing address:
  • Phone: 713-500-6577
  • Fax: 713-500-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25526
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberP9147
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: