Provider Demographics
NPI:1689611378
Name:QUINONES, JOSE A (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:QUINONES
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 1:450 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 600
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4234
Mailing Address - Country:US
Mailing Address - Phone:281-554-4300
Mailing Address - Fax:281-554-4355
Practice Address - Street 1:450 MEDICAL CENTER BLVD
Practice Address - Street 2:STE 600
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4234
Practice Address - Country:US
Practice Address - Phone:281-554-4300
Practice Address - Fax:281-554-4355
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL90452080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167577902OtherCSHCN
TX167577904Medicaid
TX167577903Medicaid
TX8H9856OtherBCBSTX
TX126121OtherSUPERIOR HEALTH PLAN
TX167577901Medicaid
TX167577904Medicaid
TX8H9856OtherBCBSTX
TX167577902OtherCSHCN
TX8C2170Medicare ID - Type Unspecified