Healthcare Provider Details

I. General information

NPI: 1730713983
Provider Name (Legal Business Name): RICARDO JORGE QUINTANA HERNANDEZ NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4734 FALLING SUN DR
HOUSTON TX
77069-1036
US

IV. Provider business mailing address

388 W LITTLE YORK RD
HOUSTON TX
77076-1303
US

V. Phone/Fax

Practice location:
  • Phone: 832-831-4883
  • Fax: 713-485-4026
Mailing address:
  • Phone: 346-476-5602
  • Fax: 713-485-4026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number979239
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1110938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: