Provider Demographics
NPI:1053369512
Name:OCON, FERNANDO JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:JOSE
Last Name:OCON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURKE RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1803
Mailing Address - Country:US
Mailing Address - Phone:713-378-6494
Mailing Address - Fax:713-378-6495
Practice Address - Street 1:3333 BURKE RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1803
Practice Address - Country:US
Practice Address - Phone:713-378-6494
Practice Address - Fax:713-378-6495
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9249207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00614QMedicare ID - Type Unspecified
TXG13740Medicare UPIN