Provider Demographics
NPI:1255320214
Name:OCHOA, ROBERTO R (MD)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:R
Last Name:OCHOA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5412 SOLEDAD LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-2029
Mailing Address - Country:US
Mailing Address - Phone:915-833-5528
Mailing Address - Fax:915-521-7920
Practice Address - Street 1:5412 SOLEDAD LN
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-2029
Practice Address - Country:US
Practice Address - Phone:915-833-5528
Practice Address - Fax:915-521-7920
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4084207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W0189OtherBCBS
TXP00399357OtherRAILROAD
TX8A5212Medicare ID - Type UnspecifiedID
TXP00399357OtherRAILROAD
TX8J2119Medicare PIN