Provider Demographics
NPI:1578535449
Name:CURUBO, MARIO (MD)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:
Last Name:CURUBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:122 W JOHN CARPENTER FWY STE 420
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2014
Mailing Address - Country:US
Mailing Address - Phone:922-957-3000
Mailing Address - Fax:972-957-3005
Practice Address - Street 1:6751 ABRAMS RD STE 108
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0213
Practice Address - Country:US
Practice Address - Phone:214-466-6376
Practice Address - Fax:214-466-6381
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI09082Medicare UPIN
TX8C9005Medicare ID - Type Unspecified