Basic Information
| Provider Information | |||||||||
| NPI: | 1740472331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAUD | ||||||||
| FirstName: | ALBERTO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 ALBERTA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152155911 | ||||||||
| FaxNumber: | 9152155969 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 ALBERTA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152155911 | ||||||||
| FaxNumber: | 9152155969 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2007 | ||||||||
| LastUpdateDate: | 05/04/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084V0102X | N7719 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 207T00000X | N7719 | TX | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 2084D0003X | N7719 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Diagnostic Neuroimaging | 2084A2900X | N7719 | TX | N | 2084N0400X | N7719 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.