Provider Demographics
NPI:1255376984
Name:LANTIN-HERMOSO, MARIA REGINA LAKI (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:REGINA LAKI
Last Name:LANTIN-HERMOSO
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:PO BOX 201088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-1088
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:713-500-5484
Practice Address - Street 1:6651 MAIN ST STE E1920
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2428
Practice Address - Country:US
Practice Address - Phone:832-826-5600
Practice Address - Fax:832-826-4287
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ78162080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125708102OtherCSHCN
TX89Y084OtherBCBS
TX370011877OtherRAILROAD MEDICARE
TX125708104Medicaid
TX125708102OtherCSHCN
TXG34724Medicare UPIN