Provider Demographics
NPI:1972538197
Name:BUITRAGO, MARIA M (DPM)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:M
Last Name:BUITRAGO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 WAUGH DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-2000
Mailing Address - Country:US
Mailing Address - Phone:832-389-2730
Mailing Address - Fax:713-522-6111
Practice Address - Street 1:810 WAUGH DR
Practice Address - Street 2:STE. 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-2000
Practice Address - Country:US
Practice Address - Phone:832-212-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1509213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1477967735OtherGROUP NPI FOOT SURGERY SPECIALISTS OF TEXAS
TX200206789Medicaid
TX0699HMedicare PIN
TX1477967735OtherGROUP NPI FOOT SURGERY SPECIALISTS OF TEXAS