Organization
ALFONSO CORDOBA M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFONSO CORDOBA M.D., P.A. (OWNER)
(281) 893-6610
Entity
Organization
Contact information
Practice address
17203 RED OAK DR., SUITE 101, HOUSTON, TX 77090
(281) 893-6610
(281) 893-3658
Mailing address
P.O. BOX 73626, HOUSTON, TX 77273-3626
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
F1476
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089849602
—
TX
Enumeration date
11/05/2010
Last updated
03/04/2011
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