Individual
HUMBERTO MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1004 W 32ND ST STE 400, AUSTIN, TX 78705-1915
(512) 454-5171
(512) 454-0704
Mailing address
1004 W 32ND ST STE 400, AUSTIN, TX 78705-1915
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K1246
TX
207R00000X
Internal Medicine Physician
Primary
K1246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047661602
—
TX
Enumeration date
01/19/2006
Last updated
06/09/2022
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