Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | P6455 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | P6455 | TX |
NPI | 1407090319 |
---|---|
Provider Name | Dr. Pedro Antonio Maldonado |
First Address | El Paso, TX 79905-1613 |
Second Address | El Paso, TX 79905-2707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 11/09/2019 |