Provider Demographics
NPI:1184656977
Name:RINCON, JOSE A JR (REGISTERED VAS TECH)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:RINCON
Suffix:JR
Gender:M
Credentials:REGISTERED VAS TECH
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1600 TRINITY ST
Mailing Address - Street 2:NONE
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7527
Mailing Address - Country:US
Mailing Address - Phone:956-581-1146
Mailing Address - Fax:956-580-1275
Practice Address - Street 1:1600 TRINITY ST
Practice Address - Street 2:NONE
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7527
Practice Address - Country:US
Practice Address - Phone:956-581-1146
Practice Address - Fax:956-580-1275
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD35737246XC2903X, 246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular Specialist
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0552DCOtherBC/BS IDENTIFICATION NUM#
TXFTVUC6Medicare PIN