Individual
JOSE RICARDO SOBREVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4302 S SUGAR RD STE 101, EDINBURG, TX 78539-9140
(956) 388-2700
(956) 388-2710
Mailing address
4302 S SUGAR RD STE 101, EDINBURG, TX 78539-9140
(956) 388-2700
(956) 388-2710
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
P2066
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
P2066
TX
208M00000X
Hospitalist Physician
P2066
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309360101
—
SC
05
—
309360103
—
TX
01
—
415040ZPGV
MEDICARE LINKED TO J RICARDO SOBREVILLA MD PLLC
TX
01
—
P01835138
RR MEDICARE
TX
Enumeration date
05/04/2009
Last updated
04/26/2019
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