| Ricardo Quezada Real Md Pllc | |
|
951 York Dr Ste 103 Desoto TX 75115-2052 | |
| (972) 866-4311 | |
| (972) 866-4312 |
| Full Name | Ricardo Quezada Real Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 951 York Dr Ste 103, Desoto, Texas |
| Authorized Official Name and Position | Ricardo Quezada (PHYSICIAN) |
| Authorized Official Contact | 9186364835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ricardo Quezada Real Md Pllc 9038 Dillon Trl Irving TX 75063-8069 Ph: (918) 636-4835 | Ricardo Quezada Real Md Pllc 951 York Dr Ste 103 Desoto TX 75115-2052 Ph: (972) 866-4311 |
| NPI Number | 1073084299 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Medicare PECOS PAC ID | 5395198428 |
|---|---|
| Medicare Enrollment ID | O20240125000812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073084299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Ricardo Manuel Quezada |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1053502435 PECOS PAC ID: 0840323176 Enrollment ID: I20180216000765 |
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