Provider Demographics
NPI:1902119316
Name:MARIANO, MARIA RIZZA DELIZO (MD)
Entity Type:Individual
Prefix:
First Name:MARIA RIZZA
Middle Name:DELIZO
Last Name:MARIANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 SOUTHMOST RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-4787
Mailing Address - Country:US
Mailing Address - Phone:956-525-7576
Mailing Address - Fax:956-525-7503
Practice Address - Street 1:2804 SOUTHMOST RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4787
Practice Address - Country:US
Practice Address - Phone:956-525-7576
Practice Address - Fax:956-525-7503
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096213208000000X, 390200000X
TXP5840208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP5840OtherTEXAS LICENSE
TX323972501Medicaid
TX323972501Medicaid