Rico Fontillas Inc

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

6501 Issued in NV

Legal business name

RICO FONTILLAS INC

Doing business as

Ricardo Fontillas MD

Practice address

1090 Wigwam Parkway
#100
Henderson, NV 89074

Phone

(702) 454-0201

Fax

(702) 454-1245

NPI assigned

May 9, 2007

Organization subpart

Yes

Parent organization

RICO FONTILLAS INCAs reported in NPPES

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

Authorized official

Name

Rico Fontillas, MD

Title

Owner

Phone

(702) 454-0201

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ricardo Fontillas MD Doing business as

Part of

Rico Fontillas Inc

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1043424443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 WIGWAM PARKWAY",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89074",
            "telephone_number": "702-454-0201",
            "fax_number": "702-454-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 WIGWAM PARKWAY",
            "address_2": "#100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89074",
            "telephone_number": "702-454-0201",
            "fax_number": "702-454-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICO FONTILLAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICO FONTILLAS INC",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "FONTILLAS",
        "authorized_official_first_name": "RICO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-454-0201",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NV",
            "license": "6501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002019612",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ricardo Fontillas MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Davontae Richardson
• Randall Richileau, CST
• Sara J Richins, APRN-CNM
• Michael Richmond
• Jonathan Michael Ricker, DO
• Kristheana Rico, RPH
• Valerie Rico
• Melissa Ann Ridella, APRN
• John Vincent Rider, PHD, MS, OTR/L
• Stuart Lee Riding, MD

• Child & Adolescent Psychiatry Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Child & Adolescent Psychiatry Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.