MEDICARE: OMAR I MADRIZ 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	208C00000X	Colon & Rectal Surgery Physician	L0390	TX

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	:	1598871204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMAR I MADRIZ M.D.

Provider Business Mailing Address
First Line	:	6550 FANNIN ST
Second Line	:	SUITE 2307
City	:	HOUSTON
State	:	TX
Zip	:	77030-2717
Country	:	US
Telephone Number	:	713-790-9250
Fax Number	:	713-790-9251

Provider Business Practice Location Address
First Line	:	915 GESSNER RD STE 725
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-2559
Country	:	US
Telephone Number	:	713-486-4680
Fax Number	:	713-464-4548

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	09/28/2023

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Directions to “ OMAR I MADRIZ M.D.” Practice Location

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