Provider Demographics
NPI:1285607275
Name:FACTORIZA, RONALDO D (MD)
Entity type:Individual
Prefix:DR
First Name:RONALDO
Middle Name:D
Last Name:FACTORIZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3638
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-3638
Mailing Address - Country:US
Mailing Address - Phone:956-541-9499
Mailing Address - Fax:956-541-1321
Practice Address - Street 1:795 PAREDES LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3096
Practice Address - Country:US
Practice Address - Phone:956-541-9499
Practice Address - Fax:956-541-1321
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046636903Medicaid
TXG77907Medicare UPIN
TX00489QMedicare ID - Type Unspecified