Basic Information
Provider Information
NPI: 1003143553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TYPALDOS SANCHEZ
FirstName: MARLENE
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TYPALDOS SANCHEZ
OtherFirstName: MARLENE
OtherMiddleName: DEL CARMEN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 5
Mailing Information
Address1: 1836 LILY MEADOWS DR
Address2:  
City: CONROE
State: TX
PostalCode: 773042948
CountryCode: US
TelephoneNumber: 7876629389
FaxNumber:  
Practice Location
Address1: 6701 FANNIN ST STE 1040
Address2:  
City: HOUSTON
State: TX
PostalCode: 770302611
CountryCode: US
TelephoneNumber: 8328223309
FaxNumber: 8328253308
Other Information
ProviderEnumerationDate: 11/04/2009
LastUpdateDate: 02/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0214X45575TXY Allopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology

No ID Information.


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