Provider Demographics
NPI:1669793238
Name:PEDIATRICS AT SHARYLAND PLANTATION, P.A.
Entity type:Organization
Organization Name:PEDIATRICS AT SHARYLAND PLANTATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-682-9559
Mailing Address - Street 1:4100 SOUTH SHARY ROAD
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572
Mailing Address - Country:US
Mailing Address - Phone:956-682-9559
Mailing Address - Fax:956-682-9768
Practice Address - Street 1:4100 SOUTH SHARY ROAD
Practice Address - Street 2:SUITE 101B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-682-9559
Practice Address - Fax:956-682-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN