Provider Demographics
NPI:1174104749
Name:CALDERON, RICARDO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:CALDERON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12235 HUNTINGTON VENTURE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3801
Mailing Address - Country:US
Mailing Address - Phone:832-655-7477
Mailing Address - Fax:
Practice Address - Street 1:12235 HUNTINGTON VENTURE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3801
Practice Address - Country:US
Practice Address - Phone:832-655-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician