Provider Demographics
NPI:1619239308
Name:JOSEPH-TALREJA, MAIRIN (MD)
Entity type:Individual
Prefix:DR
First Name:MAIRIN
Middle Name:
Last Name:JOSEPH-TALREJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAIRIN
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6431 FANNIN ST # 4.234
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6683
Mailing Address - Fax:713-500-6699
Practice Address - Street 1:6431 FANNIN ST # 4.234
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6683
Practice Address - Fax:713-500-6699
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142295207R00000X
RILP03249207R00000X
MA252764207R00000X
390200000X
TXT2190207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program