Provider Demographics
NPI:1881686152
Name:PAULINO, ARNOLD DELA CRUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:DELA CRUZ
Last Name:PAULINO
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:PO BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4009
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH83142085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00204101OtherRR MEDICARE
TX166480708OtherMEDICAID CSHCN
TX166480709Medicaid
TX166480701Medicaid
TX166480706Medicaid
TX166480707Medicaid
TX166480702Medicaid
TX8BC023OtherBLUE CROSS BLUE SHIELD
TX8BC023OtherBLUE CROSS BLUE SHIELD
TX166480708OtherMEDICAID CSHCN
G16915Medicare UPIN
TXP00204101OtherRR MEDICARE
8C1414Medicare ID - Type Unspecified
TX8K8427Medicare PIN