MEDICARE: DR. CRISTINA BOCCALANDRO 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
1	207R00000X	Internal Medicine Physician	L3924	TX
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	L3924	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8AP970	OTHER	TX	BC TEX

General Provider Information

NPI Number	:	1508890427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRISTINA BOCCALANDRO M.D.

Provider Business Mailing Address
First Line	:	6560 FANNIN ST STE 2020
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2736
Country	:	US
Telephone Number	:	713-800-6212
Fax Number	:	713-800-6241

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 2020
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2736
Country	:	US
Telephone Number	:	713-800-6212
Fax Number	:	713-800-6241

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/31/2020

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