Provider Demographics
NPI:1851334908
Name:VALDERRABANO, MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
Last Name:VALDERRABANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MIGUEL
Other - Middle Name:
Other - Last Name:VALDERRABANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-2643
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-2643
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5554207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185541303Medicaid
TX8W8474OtherBCBS
TXP01037080OtherRR MEDICARE
TX185541301Medicaid
TX185541302Medicaid
TX8W8474OtherBLUE CROSS BLUE SHIELD
TX185541304Medicaid
TX185541305Medicaid
TX185541307Medicaid
TXP01402901OtherRR MEDICARE
LA1889636Medicaid
TXP00433674OtherRAILROAD MEDICARE
TX8W8474OtherBCBS
TX185541305Medicaid
TX185541304Medicaid
TX8L4934Medicare PIN
TX340528YMVQMedicare PIN
TXTXB145793Medicare PIN
TXP01037080OtherRR MEDICARE
TX185541307Medicaid
TX340528ZSWDMedicare PIN
TXTXB145791Medicare PIN
TX340528YQ64Medicare PIN
8J4617Medicare PIN