Provider Demographics
NPI:1891131769
Name:RINCON, LILIANA (MD)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:RINCON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-4906
Mailing Address - Country:US
Mailing Address - Phone:409-763-2452
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-4906
Practice Address - Country:US
Practice Address - Phone:409-772-1011
Practice Address - Fax:409-772-5683
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6661207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology