MEDICARE: ALBERTO A.J. MAILLARD, M.D., P.A.

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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285699421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERTO A.J. MAILLARD, M.D., P.A.

Provider Business Mailing Address
First Line	:	6410 FANNIN ST
Second Line	:	SUITE 1508
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	713-790-0239
Fax Number	:	713-790-1262

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST
Second Line	:	SUITE 1508
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	713-790-0239
Fax Number	:	713-790-1262

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALBERTO A.J. MAILLARD
Credential	:	MD
Telephone Number	:	713-790-0239

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	08/08/2016

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Directions to “ALBERTO A.J. MAILLARD, M.D., P.A. ” Practice Location

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