Provider Demographics
NPI:1104937432
Name:MERINO, ORLANDO RODOLFO (MD)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:RODOLFO
Last Name:MERINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 TEALMEADOW CT HOUSTON TX
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:713-468-0168
Mailing Address - Fax:
Practice Address - Street 1:VA MEDICAL CENTER 2002 HOLCOMBE BLVD HOUSTON TX 77030
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-794-7190
Practice Address - Fax:713-794-7825
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE45232085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP083R1020Medicaid
83R102Medicare ID - Type Unspecified
TXP083R1020Medicaid