MEDICARE: RICARDO ANTONIO CISNEROS DDS

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	1223P0700X	Prosthodontics	42002	TX

General Provider Information

NPI Number	:	1205703683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO ANTONIO CISNEROS DDS

Provider Business Mailing Address
First Line	:	1901 POST OAK BLVD APT 3405
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-3940
Country	:	US
Telephone Number	:	832-722-9623
Fax Number	:

Provider Business Practice Location Address
First Line	:	13146 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-7200
Country	:	US
Telephone Number	:	713-468-7222
Fax Number	:

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

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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Directions to “ RICARDO ANTONIO CISNEROS DDS” Practice Location

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