Healthcare Provider Details
I. General information
NPI: 1447317342
Provider Name (Legal Business Name): ALDO FERNANDO BEJARANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
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
P.O. BOX 2264 SUITE 230
PEARLAND TX
77588
US
V. Phone/Fax
- Phone: 832-386-9200
- Fax: 832-386-9203
- Phone: 832-386-9200
- Fax: 832-386-9203
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | K0631 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: