Provider Demographics
NPI:1184885295
Name:FERNANDEZ FALCON, MARIA F (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:F
Last Name:FERNANDEZ FALCON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:F
Other - Last Name:RICCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9000
Mailing Address - Fax:210-224-6367
Practice Address - Street 1:3939 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2291
Practice Address - Country:US
Practice Address - Phone:210-450-6120
Practice Address - Fax:210-576-1437
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6295208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214899104Medicaid