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NPI Code Detail

MEDICARE: ODETTE ARREDONDO MD

MEDICARE:   ODETTE  ARREDONDO  MD
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
1207Q00000XFamily Medicine PhysicianL4229TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2153400002OTHERTXCIDC
38FT349OTHERTXBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235219650
Entity Type Code : Individual
Provider Name (Legal Business Name) : ODETTE ARREDONDO MD
Provider Business Mailing Address
First Line : 5110 BUFFALO SPEEDWAY
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77005-4218
Country : US
Telephone Number : 713-363-7460
Fax Number :
Provider Business Practice Location Address
First Line : 5110 BUFFALO SPEEDWAY
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77005-4218
Country : US
Telephone Number : 713-363-7460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/17/2018

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