MEDICARE: DR. MARIA CHERIAN 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
1	208000000X	Pediatrics Physician	010609	GA
2	208000000X	Pediatrics Physician	25MA11220700	NJ
3	390200000X	Student in an Organized Health Care Education/Training Program	BP10086945	TX

General Provider Information

NPI Number	:	1265937262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA CHERIAN MD

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-6457
Country	:	US
Telephone Number	:	214-648-3433
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-6136
Country	:	US
Telephone Number	:	214-648-3433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2018
Last Update Date	:	06/28/2024

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