Provider Demographics
NPI:1578880985
Name:OCHOA, JOSE A (DDS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:OCHOA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 E EXPRESSWAY 83
Mailing Address - Street 2:STE 50
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1019
Mailing Address - Country:US
Mailing Address - Phone:956-583-5430
Mailing Address - Fax:956-583-5431
Practice Address - Street 1:3601 BUDDY OWENS AVE STE 200
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6447
Practice Address - Country:US
Practice Address - Phone:956-631-4200
Practice Address - Fax:956-631-4201
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59240122300000X
TX253821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist