Provider Demographics
NPI:1659569028
Name:GIRALDI, RODOLFO G (MD)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:G
Last Name:GIRALDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12520 WESTHEIMER RD
Mailing Address - Street 2:A-1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5861
Mailing Address - Country:US
Mailing Address - Phone:713-781-0454
Mailing Address - Fax:281-293-9605
Practice Address - Street 1:10618 WESTHEIMER ROAD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:713-781-0454
Practice Address - Fax:281-293-9605
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ0503OtherMEDICAL LICENSE
TXJ0503OtherMEDICAL LICENSE
TX614333Medicare PIN