Provider Demographics
NPI:1528402823
Name:PEDROZA, RICHARD ANDRES (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANDRES
Last Name:PEDROZA
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 1:12120 JONES RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5280
Mailing Address - Country:US
Mailing Address - Phone:832-678-8252
Mailing Address - Fax:832-678-8253
Practice Address - Street 1:12120 JONES RD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5280
Practice Address - Country:US
Practice Address - Phone:832-678-8252
Practice Address - Fax:832-678-8253
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ9001207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine