Provider Demographics
NPI:1306966031
Name:ALBARADO, BILL J (DO)
Entity type:Individual
Prefix:DR
First Name:BILL
Middle Name:J
Last Name:ALBARADO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 MORGAN SUITE 113
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405
Mailing Address - Country:US
Mailing Address - Phone:361-882-5417
Mailing Address - Fax:
Practice Address - Street 1:2222 MORGAN SUITE 113
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405
Practice Address - Country:US
Practice Address - Phone:361-882-5417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1992029854OtherPROVIDER IDENTIFIER NUMBER OF PROFESSIONAL ASSOCIATION
TX115618401Medicaid
TXP000N9256Medicaid
TXP000N9256Medicaid
TXTXB106013Medicare PIN