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NPI Code Detail

MEDICARE: MARIA LUISA REVERT FONT M.D.

MEDICARE: MARIA LUISA REVERT FONT 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
1208000000XPediatrics PhysicianN4034TX

General Provider Information

NPI Number : 1083034268
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA LUISA REVERT FONT M.D.
Provider Business Mailing Address
First Line : PO BOX 230209
Second Line :
City : HOUSTON
State : TX
Zip : 77223-0209
Country : US
Telephone Number : 713-660-1880
Fax Number : 713-926-9105
Provider Business Practice Location Address
First Line : 7635 CANAL ST
Second Line :
City : HOUSTON
State : TX
Zip : 77012-1143
Country : US
Telephone Number : 832-723-4303
Fax Number : 713-926-9105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2014
Last Update Date : 04/26/2014

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