RICARDO CRISTOBAL (NPI# 1801059514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801059514 |
Entity Type | Individual |
Full Name | RICARDO CRISTOBAL |
Credential | MD |
Practice Address |
923 Pennsylvania Ave Suite 200 Fort Worth TX 76104-2254 |
Mailing Address |
Po Box 961205 Fort Worth TX 76161-1205 |
Practice Telephone | 8179200484 |
Practice Fax Number | 8179200389 |
Mailing Telephone | 8177408400 |
Mailing Fax Number | 8179200389 |
Enumeration Date | 2008-07-03 |
Last Update Date | 2015-08-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Y00000X | Otolaryngology | M9939 | TX | Allopathic & Osteopathic Physicians |
Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
M9939 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 196011401 | 05 | |
TX | CSHCN MEDICAID | 196011402 | 01 |
TX | RAIL ROAD MEDICARE | P00643338 | 01 |
Street Address |
923 PENNSYLVANIA AVE SUITE 200 |
City | FORT WORTH |
State | TX |
Zip Code | 76104-2254 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538186150 | Andrew A Vories | Otolaryngology | 923 Pennsylvania Ave, Suite 200, Fort Worth, TX 76104-2254 | 2006-07-17 |
1679978670 | Amanda Jane Davis | Nurse Practitioner | 923 Pennsylvania Ave, Suite 200, Fort Worth, TX 76104-2254 | 2014-11-03 |
1235568429 | Lauren Leblanc | Nurse Practitioner | 923 Pennsylvania Ave, 100, Fort Worth, TX 76104-2254 | 2013-11-07 |
1245669423 | Amy Williamson | Nurse Practitioner | 923 Pennsylvania Ave, Suite #100, Fort Worth, TX 76104-2254 | 2013-11-07 |
1750573226 | Julian Xavier Cruz | Specialist/Technologist, Other | 923 Pennsylvania Ave, Suite 100, Fort Worth, TX 76104 | 2007-08-17 |
1619989217 | Mindy H Meeker | Physician Assistant | 923 Pennsylvania Ave, Suite 100, Fort Worth, TX 76104-2254 | 2006-08-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
Find all providers in zip 76104 |
Taxonomy Code | 207YX0901X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
Specialization | Otology & Neurotology |
An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851710032 | Wesley W.o. Krueger M.d. Pllc | Otolaryngology | 2632 Broadway St Ste 201, San Antonio, TX 78215-1137 | 2014-04-15 |
1538506498 | Eric Nicholas Appelbaum | Otolaryngology | 6501 Fannin St Ste Nb302, Houston, TX 77030-2703 | 2013-05-31 |
1700069838 | Claude A Mclelland Md | Otolaryngology | 3301 S Alameda, #506, Corpus Christi, TX 78411 | 2007-12-12 |
1003096819 | Cherie L. Booth | Otolaryngology | 4104 Junius St, Dallas, TX 75246-1427 | 2007-11-08 |
1225115876 | Kendal Lance Stewart | Otolaryngology | 11719 Bee Cave Rd. #204, Bee Cave, TX 78738-5543 | 2006-11-01 |
1194792739 | Robert M Owens | Otolaryngology | 6509 W Plano Pkwy, Plano, TX 75093-8209 | 2006-03-02 |
1467440180 | Patrick W Slater | Otolaryngology | 12319 N Mopac Expy, Bldg. C, Sutie 300, Austin, TX 78758-2403 | 2005-10-06 |
1093236325 | Chenxi You | Otolaryngology | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2017-06-27 |
1306180781 | Marc-elie Nader | Otolaryngology | 1515 Holcombe Blvd, Houston, TX 77030-4009 | 2012-11-25 |
1932497443 | Total Senior Ear Care, Corp | Otolaryngology | 9535 Forest Lane, Suite 123, Dallas, TX 75243 | 2011-07-18 |
Find all providers with the same taxonomy |
City | FORT WORTH |
Zip Code | 76104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.