Provider Demographics
NPI:1558165381
Name:MEDRANO, GERALDO (MD)
Entity type:Individual
Prefix:
First Name:GERALDO
Middle Name:
Last Name:MEDRANO
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 ARDMORE ST APT 1148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3507
Mailing Address - Country:US
Mailing Address - Phone:713-240-3922
Mailing Address - Fax:
Practice Address - Street 1:424 HAHLO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-3022
Practice Address - Country:US
Practice Address - Phone:346-548-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program