Provider Demographics
NPI:1568411213
Name:HORRILLENO, ALMA C (MD)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:C
Last Name:HORRILLENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 W. RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012
Mailing Address - Country:US
Mailing Address - Phone:817-502-7411
Mailing Address - Fax:
Practice Address - Street 1:6210 CAMPBELL RD
Practice Address - Street 2:SUITE 225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1379
Practice Address - Country:US
Practice Address - Phone:972-931-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2151208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0402Medicare ID - Type Unspecified