Provider Demographics
NPI:1881796829
Name:ORELLANA, HUGO (MD)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:
Last Name:ORELLANA
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 1:4014 WOODLAWN AVE., STE. A
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1995
Mailing Address - Country:US
Mailing Address - Phone:713-946-8413
Mailing Address - Fax:713-946-8567
Practice Address - Street 1:4014 WOODLAWN AVE STE A
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1921
Practice Address - Country:US
Practice Address - Phone:713-946-8413
Practice Address - Fax:713-946-8567
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7214174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1227118-02Medicaid
TX741985185OtherTAX ID
TXE7214OtherMEDICAL LICENSE
TX1227118-02Medicaid
TX00BC08Medicare ID - Type UnspecifiedPROVIDER NUMBER