Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | K9363 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | K9363 | TX |
NPI | 1336126192 |
---|---|
Provider Name | Ricardo A. Mosquera |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-1501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 06/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038610402 | (05) | TX |
038610408 (MDACC) | (05) | TX |
8DD192 | BCBS (MDACC) (01) | TX |
H08396 | (02) | TX |