Provider Demographics
NPI:1902897341
Name:MALDONADO, ELAINE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:MARIE
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1901 BABCOCK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4554
Mailing Address - Country:US
Mailing Address - Phone:210-341-7722
Mailing Address - Fax:210-342-8616
Practice Address - Street 1:1901 BABCOCK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4554
Practice Address - Country:US
Practice Address - Phone:210-341-7722
Practice Address - Fax:210-342-8616
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK78132080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038849802Medicaid
TX8D8044Medicare PIN
TXH11067Medicare UPIN