Provider Demographics
NPI:1609206358
Name:HURTADO-SBORDONI, MARIANA (DO)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:HURTADO-SBORDONI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9090 KATY FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1696
Mailing Address - Country:US
Mailing Address - Phone:832-522-8720
Mailing Address - Fax:
Practice Address - Street 1:9090 KATY FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1696
Practice Address - Country:US
Practice Address - Phone:832-522-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-16
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283076207R00000X
TXR0588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine