Provider Demographics
NPI:1477967735
Name:MARIA M BUITRAGO, DPM, PA
Entity Type:Organization
Organization Name:MARIA M BUITRAGO, DPM, PA
Other - Org Name:FOOT SURGERY SPECIALISTS OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:BUITRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:832-386-2730
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:
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:832-389-2730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1509213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU83203Medicare UPIN
0699HMedicare PIN