Provider Demographics
NPI:1942200845
Name:OCHOA, ALFONSO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFONSO
Middle Name:
Last Name:OCHOA
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 1:909 S AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6651
Mailing Address - Country:US
Mailing Address - Phone:956-968-0560
Mailing Address - Fax:956-969-0014
Practice Address - Street 1:909 S AIRPORT DR
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6651
Practice Address - Country:US
Practice Address - Phone:956-968-0560
Practice Address - Fax:956-969-0014
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7297207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157639901Medicaid
TX00FY92OtherBLUE CROSS BLUE SHIELD
TX00762UMedicare ID - Type Unspecified
TX00FY92OtherBLUE CROSS BLUE SHIELD