Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | P9147 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | 25526 | AL |
NPI | 1710917794 |
---|---|
Provider Name | Dr. Iliana Arellano |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-1501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 24/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009938985 | (05) | AL |
051519247 | BLUE SHIELD PROVIDER NUMB (01) | AL |
051519247 | MEDICARE (01) | AL |
25526 | MEDICAL LICENSE (01) | AL |
BA8204721 | DEA (01) | |
H99125 | (02) |