Provider Demographics
NPI:1881610657
Name:RCDC INC,
Entity type:Organization
Organization Name:RCDC INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:PEREZ
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RCP
Authorized Official - Phone:210-733-7887
Mailing Address - Street 1:1715 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-4643
Mailing Address - Country:US
Mailing Address - Phone:210-733-7887
Mailing Address - Fax:210-734-5993
Practice Address - Street 1:1715 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-4643
Practice Address - Country:US
Practice Address - Phone:210-733-7887
Practice Address - Fax:210-734-5993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BX2000X332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154899202Medicaid
5515770001Medicare UPIN