Provider Demographics
NPI:1295716025
Name:CAMACHO, MARIA T (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 534358
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-4358
Mailing Address - Country:US
Mailing Address - Phone:956-421-2414
Mailing Address - Fax:956-421-3321
Practice Address - Street 1:102 N NUECES PARK LN
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-6235
Practice Address - Country:US
Practice Address - Phone:956-421-2414
Practice Address - Fax:956-421-3321
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL39342080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155603706Medicaid
TX155603701Medicaid
TXH74762Medicare UPIN