Provider Demographics
NPI:1902893365
Name:RON, VICTOR HUGO (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:HUGO
Last Name:RON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MEDICAL PKWY
Mailing Address - Street 2:STE 301
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7859
Mailing Address - Country:US
Mailing Address - Phone:972-620-2696
Mailing Address - Fax:972-620-0382
Practice Address - Street 1:8 MEDICAL PKWY
Practice Address - Street 2:STE 301
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7859
Practice Address - Country:US
Practice Address - Phone:972-620-2696
Practice Address - Fax:972-620-0382
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143085201Medicaid
TX143085201Medicaid
00481RMedicare ID - Type Unspecified