Provider Demographics
NPI:1972512598
Name:ALINDADA, JULIANA B (MD)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:B
Last Name:ALINDADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:B
Other - Last Name:BAUTISTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935
Mailing Address - Country:US
Mailing Address - Phone:936-598-5160
Mailing Address - Fax:936-598-5237
Practice Address - Street 1:602 HURST ST.
Practice Address - Street 2:SUITE 3
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935
Practice Address - Country:US
Practice Address - Phone:936-598-5160
Practice Address - Fax:936-598-5237
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7773174400000X, 207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1269300-03Medicaid
TX1269300-02Medicaid
TX1269300-02Medicaid
TX00JY96Medicare PIN