Basic Information
Provider Information
NPI: 1174845937
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MALDONADO
FirstName: KARLA
MiddleName: I
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 GREENWAY PLZ
Address2:  
City: HOUSTON
State: TX
PostalCode: 770460297
CountryCode: US
TelephoneNumber: 7137981835
FaxNumber: 7137981144
Practice Location
Address1: 1504 TAUB LOOP
Address2: ANESTHESIA DEPARTMENT
City: HOUSTON
State: TX
PostalCode: 770301608
CountryCode: US
TelephoneNumber: 7138732000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/22/2010
LastUpdateDate: 06/10/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X725347TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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