Provider Demographics
NPI:1861505539
Name:PINEDA, RAMON ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ANTONIO
Last Name:PINEDA
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 1:2418 EAST SOUTHMORE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502
Mailing Address - Country:US
Mailing Address - Phone:713-472-2700
Mailing Address - Fax:713-472-4216
Practice Address - Street 1:2418 EAST SOUTHMORE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502
Practice Address - Country:US
Practice Address - Phone:713-472-2700
Practice Address - Fax:713-472-4216
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010029302OtherMEDICARE RAIL ROAD #
TX10014906OtherAMERIGROUP MEDICAID
TX137970308Medicaid
TX85613ZOtherBCBS HMO #
TX00D53POtherBCBS PPO #
TX76-0367510OtherTAX ID #
TX00D53POtherBCBS PPO #
TXE18887Medicare UPIN