Provider Demographics
NPI:1386937761
Name:RAUL OCHOA MALDONADO DPM, PA
Entity type:Organization
Organization Name:RAUL OCHOA MALDONADO DPM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:OCHOA
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:956-365-3334
Mailing Address - Street 1:597 W SESAME DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8364
Mailing Address - Country:US
Mailing Address - Phone:956-365-3334
Mailing Address - Fax:956-365-4656
Practice Address - Street 1:597 W SESAME DR
Practice Address - Street 2:SUITE G
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8364
Practice Address - Country:US
Practice Address - Phone:956-365-3334
Practice Address - Fax:956-365-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1348213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018574601Medicaid
TX018574601Medicaid
TX00107EMedicare PIN