Basic Information
| Provider Information | |||||||||
| NPI: | 1336438878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MADARANG | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 917 S PORT AVE | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784052301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618831879 | ||||||||
| FaxNumber: | 3618831881 | ||||||||
| Practice Location | |||||||||
| Address1: | 4254 S ALAMEDA ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615004351 | ||||||||
| FaxNumber: | 8887111008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2011 | ||||||||
| LastUpdateDate: | 07/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N8811 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207P00000X | N8811 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.