Provider Demographics
NPI:1568471159
Name:POCURULL, RICARDO LUIS (MD)
Entity Type:Individual
Prefix:MR
First Name:RICARDO
Middle Name:LUIS
Last Name:POCURULL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1725 BIRMINGHAM RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4081
Mailing Address - Country:US
Mailing Address - Phone:979-696-8000
Mailing Address - Fax:979-696-8100
Practice Address - Street 1:1725 BIRMINGHAM RD
Practice Address - Street 2:STE 200
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845
Practice Address - Country:US
Practice Address - Phone:979-696-8000
Practice Address - Fax:979-696-8100
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2019-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2776207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131273100OtherFIRSTCARE
TX152068601Medicaid
TX8AJ660OtherBCBS OF TEXAS
TX660003931OtherRAILROAD MEDICARE
TX61890OtherAMERIGROUP MEDICAID
TX8847B6Medicare PIN
TX61890OtherAMERIGROUP MEDICAID