1104050061 NPI number — CLAUDIO CONSTANTINO TOLEDO M.D.

Table of content: CLAUDIO CONSTANTINO TOLEDO M.D. (NPI 1104050061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104050061 NPI number — CLAUDIO CONSTANTINO TOLEDO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOLEDO
Provider First Name:
CLAUDIO
Provider Middle Name:
CONSTANTINO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104050061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 BARTLETT DR
Provider Second Line Business Mailing Address:
APT. 1103
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79912-1608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-412-8735
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19851 HIGHWAY 46 W
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
SPRING BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-277-2222
Provider Business Practice Location Address Fax Number:
210-703-0934
Provider Enumeration Date:
05/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  P2169 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: P2169 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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