Provider Demographics
NPI:1053390088
Name:CICORA, RALPH ALLEN (DO)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:ALLEN
Last Name:CICORA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4025 SPID
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4420
Mailing Address - Country:US
Mailing Address - Phone:361-852-8255
Mailing Address - Fax:361-225-0810
Practice Address - Street 1:4025 SPID DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4420
Practice Address - Country:US
Practice Address - Phone:361-852-8255
Practice Address - Fax:361-225-0810
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF9304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine