Provider Demographics
NPI:1275712432
Name:RICARDO PINERO MD PA
Entity Type:Organization
Organization Name:RICARDO PINERO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:F
Authorized Official - Last Name:PINERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-704-4504
Mailing Address - Street 1:8600 WURZBACH RD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4330
Mailing Address - Country:US
Mailing Address - Phone:210-704-4504
Mailing Address - Fax:
Practice Address - Street 1:333 N SANTA ROSA
Practice Address - Street 2:SUITE F2658
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7887174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082475701Medicaid
TX082475701Medicaid
TXC20532Medicare UPIN