Provider Demographics
NPI:1225267768
Name:RIBAS ROCA, JOSE ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:RIBAS ROCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:ANTONIO
Other - Last Name:RIBAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1977 BUTLER BLVD STE E4.400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4101
Mailing Address - Country:US
Mailing Address - Phone:713-798-4857
Mailing Address - Fax:713-798-3138
Practice Address - Street 1:1977 BUTLER BLVD STE E4.400
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4101
Practice Address - Country:US
Practice Address - Phone:713-798-4857
Practice Address - Fax:713-798-3138
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC155836390200000X
TXR09422084P0015X
MA2545232084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program