Provider Demographics
NPI:1659339471
Name:ADOLFO A. ALDAPE, M.D.P.A.
Entity Type:Organization
Organization Name:ADOLFO A. ALDAPE, M.D.P.A.
Other - Org Name:ADOLFO A. ALDAPE,M.D.P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALDAPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-795-8265
Mailing Address - Street 1:1710 E SAUNDERS
Mailing Address - Street 2:SUITE B660
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6850
Mailing Address - Country:US
Mailing Address - Phone:956-795-8265
Mailing Address - Fax:956-795-8268
Practice Address - Street 1:1710 E SAUNDERS
Practice Address - Street 2:SUITE B660
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6850
Practice Address - Country:US
Practice Address - Phone:956-795-8265
Practice Address - Fax:956-795-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9971207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0014JAOtherBLUE CROSS BLUE SHIELD OF TEXAS
TX153446303Medicaid
TX0014JAOtherBLUE CROSS BLUE SHIELD OF TEXAS
TX153446303Medicaid