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NPI Code Detail

MEDICARE: MAVERICK COUNTY RURAL RADIOLOGISTS P A

MEDICARE: MAVERICK COUNTY RURAL RADIOLOGISTS P A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437117181
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAVERICK COUNTY RURAL RADIOLOGISTS P A
Provider Business Mailing Address
First Line : PO BOX 9730
Second Line :
City : LONGVIEW
State : TX
Zip : 75608-9730
Country : US
Telephone Number : 903-663-4800
Fax Number : 903-663-9960
Provider Business Practice Location Address
First Line : 3333 N FOSTER MALDONADO BLVD
Second Line :
City : EAGLE PASS
State : TX
Zip : 78852-5893
Country : US
Telephone Number : 830-773-5321
Fax Number :
Authorized Official
Title or Position : MD/OWNER
Name : ABRAHAM DANIEL RAFIE
Credential : MD
Telephone Number : 913-777-1765
Provider Enumeration Date : 05/03/2006
Last Update Date : 10/31/2023

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Directions to “MAVERICK COUNTY RURAL RADIOLOGISTS P A ” Practice Location

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