MEDICARE: DR. ANGELO P GIARDINO 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	M1112	TX

General Provider Information

NPI Number	:	1528009578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGELO P GIARDINO MD

Provider Business Mailing Address
First Line	:	PO BOX 301011
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77230-1011
Country	:	US
Telephone Number	:	832-828-1216
Fax Number	:	832-825-8765

Provider Business Practice Location Address
First Line	:	2450 HOLCOMBE BLVD
Second Line	:	SUITE 34L
City	:	HOUSTON
State	:	TX
Zip	:	77021-2039
Country	:	US
Telephone Number	:	832-828-1216
Fax Number	:	832-825-8765

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	12/17/2021

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