MEDICARE: DR. RICARDO HIDALGO D.D.S.

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	1223G0001X	General Practice Dentistry	14311	TX

General Provider Information

NPI Number	:	1396732897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO HIDALGO D.D.S.

Provider Business Mailing Address
First Line	:	1930 W 18TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1275
Country	:	US
Telephone Number	:	713-868-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 W 18TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1275
Country	:	US
Telephone Number	:	713-868-1900
Fax Number	:

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	05/04/2015

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Directions to “ DR. RICARDO HIDALGO D.D.S.” Practice Location

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