Provider Demographics
NPI:1992029854
Name:BILL ALBARADO DOPA
Entity Type:Organization
Organization Name:BILL ALBARADO DOPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBARADO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-882-5417
Mailing Address - Street 1:2222 MORGAN AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1948
Mailing Address - Country:US
Mailing Address - Phone:361-882-5417
Mailing Address - Fax:361-882-5418
Practice Address - Street 1:2222 MORGAN AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1948
Practice Address - Country:US
Practice Address - Phone:361-882-5417
Practice Address - Fax:361-882-5418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115618401Medicaid
TXP00N9256Medicaid
TXTXB106012Medicare PIN
TXTXB106012Medicare UPIN