Larry A Maldonado, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA03146 Issued in TX

Practice address

4461 Coit Rd
Suite 405
Frisco, TX 75035-0521

Phone

(972) 377-9200

Fax

(972) 377-9300

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1962446450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "SUITE 405",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350521",
            "telephone_number": "972-377-9200",
            "fax_number": "972-377-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 COIT RD",
            "address_2": "SUITE 405",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350521",
            "telephone_number": "972-377-9200",
            "fax_number": "972-377-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LARRY",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Frisco, TX
• Providers in Frisco, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.