Provider Demographics
NPI:1427768480
Name:USECHE DE MUJICA, DULCE C (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:C
Last Name:USECHE DE MUJICA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 HIGHWAY 6 S APT 4059
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1070
Mailing Address - Country:US
Mailing Address - Phone:786-781-8460
Mailing Address - Fax:
Practice Address - Street 1:4704 MONTROSE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6122
Practice Address - Country:US
Practice Address - Phone:713-333-0151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1295-PA156FX1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant