Provider Demographics
NPI:1285860080
Name:BELLERA, RICARDO VINCENTE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:VINCENTE
Last Name:BELLERA
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 1:18980 W MEMORIAL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4394
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18980 W. MEMORIAL DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:832-644-8930
Practice Address - Fax:855-227-3506
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3490207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1285860080OtherNPI
TX205908102Medicaid
TX205908103Medicaid
TXP01120337OtherRR MEDICARE
TX205908101OtherMEDICAID TPI
TX8CC144OtherBCBSTX
TXP01120337OtherRR MEDICARE
TXTXB155320Medicare PIN
TX340835YMVQMedicare PIN