MEDICARE: RICARDO JORGE QUINTANA HERNANDEZ NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	1110938	TX
2	163W00000X	Registered Nurse	979239	TX

General Provider Information

NPI Number	:	1730713983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO JORGE QUINTANA HERNANDEZ NP

Provider Business Mailing Address
First Line	:	388 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1303
Country	:	US
Telephone Number	:	346-476-5602
Fax Number	:	713-485-4026

Provider Business Practice Location Address
First Line	:	388 W LITTLE YORK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1303
Country	:	US
Telephone Number	:	346-423-2284
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	03/26/2026

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