MEDICARE: RICARDO ROCHA MD

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	207Q00000X	Family Medicine Physician	D3385	TX

General Provider Information

NPI Number	:	1912922444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO ROCHA MD

Provider Business Mailing Address
First Line	:	3620 DOUGLAS AVE.
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2831
Country	:	US
Telephone Number	:	214-522-3930
Fax Number	:	214-522-7338

Provider Business Practice Location Address
First Line	:	3620 DOUGLAS AVE.
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2831
Country	:	US
Telephone Number	:	214-522-3930
Fax Number	:	214-522-7338

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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