Provider Demographics
NPI:1649244039
Name:PLAVIDAL, FERDINAND J (MD)
Entity Type:Individual
Prefix:
First Name:FERDINAND
Middle Name:J
Last Name:PLAVIDAL
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 1:7580 FANNIN ST
Mailing Address - Street 2:SUITE 335
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1900
Mailing Address - Country:US
Mailing Address - Phone:713-795-5450
Mailing Address - Fax:713-795-0250
Practice Address - Street 1:7580 FANNIN ST
Practice Address - Street 2:SUITE 335
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1900
Practice Address - Country:US
Practice Address - Phone:713-795-5450
Practice Address - Fax:713-795-0250
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0583207V00000X
LA012027207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123674704Medicaid
TX123674705Medicaid
TX123674705Medicaid
TX00N854Medicare ID - Type Unspecified
TX123674704Medicaid