Jesus D Ucol MD PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J9407 Issued in TX

Legal business name

JESUS D UCOL MD PA

Practice address

1718 10TH St
Suite a
Wichita Falls, TX 76301

Phone

(940) 761-5437

Fax

(940) 761-5400

NPI assigned

Sep 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jesus D Ucol, MDNPI 1861493231

Title

Jesus Ucol MD PA

Phone

(940) 261-3437

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jesus D Ucol MD Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesus D Ucol, MD PA

  • Pediatrics Physician
  • Wichita Falls, TX
  • NPI 1861493231
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003908351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4167",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-761-5437",
            "fax_number": "940-761-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 10TH ST",
            "address_2": "SUITE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76301",
            "telephone_number": "940-761-5437",
            "fax_number": "940-761-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS D UCOL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UCOL",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "JESUS UCOL MD PA",
        "authorized_official_telephone_number": "940-261-3437",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J9407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1211940801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1211940803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jesus D Ucol MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatrics Physician in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.