Healthcare Provider Details

I. General information

NPI: 1083771885
Provider Name (Legal Business Name): ALDO F BEJARANO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3326 WATTERS RD BLDG D
PASADENA TX
77504-2053
US

IV. Provider business mailing address

PO BOX 2264
PEARLAND TX
77588
US

V. Phone/Fax

Practice location:
  • Phone: 832-386-9200
  • Fax: 832-386-9203
Mailing address:
  • Phone: 832-386-9200
  • Fax: 832-386-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK0631
License Number StateTX

VIII. Authorized Official

Name: DR. ALDO FERNANDO BEJARANO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 832-386-9200