Provider Demographics
NPI:1699018705
Name:RICONDO, STEVEN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ANTHONY
Last Name:RICONDO
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 1:6701 FANNIN ST STE 1710
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2616
Mailing Address - Country:US
Mailing Address - Phone:832-822-3666
Mailing Address - Fax:832-825-3689
Practice Address - Street 1:6701 FANNIN ST STE 1710
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2616
Practice Address - Country:US
Practice Address - Phone:832-822-3666
Practice Address - Fax:832-825-3689
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS75412080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine