Basic Information
| Provider Information | |||||||||
| NPI: | 1124227533 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LA HOZ | ||||||||
| FirstName: | RICARDO | ||||||||
| MiddleName: | MARTIN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LA HOZ CHUNGA | ||||||||
| OtherFirstName: | RICARDO | ||||||||
| OtherMiddleName: | MARTIN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 845347 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752845347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146452800 | ||||||||
| FaxNumber: | 2146452808 | ||||||||
| Practice Location | |||||||||
| Address1: | 5323 HARRY HINES BLVD | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753907201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146452800 | ||||||||
| FaxNumber: | 2146452808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2007 | ||||||||
| LastUpdateDate: | 01/27/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 2013-01749 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | Q2323 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207R00000X | Q2323 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.