Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | L2441 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | L2441 | TX |
Y | 207RP1001X | Pulmonary Disease | L2441 | TX |
N | 207RS0012X | Sleep Medicine | L2441 | TX |
NPI | 1386624476 |
---|---|
Provider Name | David Maldonado III |
First Address | North Richland Hills, TX 76182-2087 |
Second Address | Fort Worth, TX 76132-6103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 22/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
196242501 | (05) | TX |