Healthcare Provider Details

I. General information

NPI: 1184243917
Provider Name (Legal Business Name): POMPEYO RAFAEL QUESADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2020
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD # MS 3010
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

1127 HARVEY ST
MCALLEN TX
78501-4053
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6739
  • Fax:
Mailing address:
  • Phone: 956-467-9578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberV6086
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: