Provider Demographics
NPI:1710917794
Name:ARELLANO, ILIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ILIANA
Middle Name:
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN ST # 1.240A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6577
Mailing Address - Fax:713-500-6556
Practice Address - Street 1:6431 FANNIN ST # 1.240A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6577
Practice Address - Fax:713-500-6556
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25526207RC0000X
TXP9147207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051519247OtherMEDICARE
AL009938985Medicaid
AL25526OtherMEDICAL LICENSE
AL051519247OtherBLUE SHIELD PROVIDER NUMB
AL051519247OtherBLUE SHIELD PROVIDER NUMB
AL051519247OtherBLUE SHIELD PROVIDER NUMB
AL051519247OtherMEDICARE