Provider Demographics
NPI:1619022902
Name:PALACIO, HERMINIA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:HERMINIA
Middle Name:
Last Name:PALACIO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 WEST LOOP S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3588
Mailing Address - Country:US
Mailing Address - Phone:713-439-6016
Mailing Address - Fax:
Practice Address - Street 1:2223 WEST LOOP S
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3588
Practice Address - Country:US
Practice Address - Phone:713-439-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2528207R00000X
CAG65640207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE96020Medicare UPIN