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General NPI Number Information
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NPI Number | 1902048358
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Entity Type | Organization
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Legal Business Name | ORLANDO FONSECA, MD, PLLC
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 9190 KATY FWY SUITE 201
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City | HOUSTON
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State | TX
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Zip | 77055-7455
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Country | US
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Telephone | 713-464-1919
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Fax |
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Provider Business Mailing Address
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Address Line | 9190 KATY FWY STE 201
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City | HOUSTON
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State | TX
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Zip | 77055-7444
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Country | US
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Telephone | 713-464-1919
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Fax |
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Authorized Official
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Title or Position | OWNER, INTERNAL MEDICINE PHYSICIAN
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Name | DR. ORLANDO FONSECA
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Credential | M.D.
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Telephone | 713-464-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M6133
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License Number State | TX
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