Provider Demographics
NPI:1922017409
Name:PATINO, MARIA OLGA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:OLGA
Last Name:PATINO
Suffix:
Gender:F
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 4356
Mailing Address - Street 2:DEPARTMENT 667
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4356
Mailing Address - Country:US
Mailing Address - Phone:281-586-3888
Mailing Address - Fax:281-440-2020
Practice Address - Street 1:837 FM 1960 WEST
Practice Address - Street 2:SUITE 105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-0000
Practice Address - Country:US
Practice Address - Phone:281-586-3888
Practice Address - Fax:281-440-2020
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL94222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL9422OtherLICENSE
TX8BZ814OtherBCBS
TX8L8061Medicare PIN
TX8L8060Medicare PIN
I21889Medicare UPIN
TX8L7932Medicare PIN
TX8BZ814OtherBCBS
TX8C9138Medicare ID - Type Unspecified
TX8L8062Medicare PIN
TX8L13662Medicare PIN