Healthcare Provider Details

I. General information

NPI: 1013255470
Provider Name (Legal Business Name): RAFAEL J FEBRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2013
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 RED BLUFF RD STE 150
PASADENA TX
77503-3307
US

IV. Provider business mailing address

PO BOX 650859, DEPT. 710
DALLAS TX
75265-0859
US

V. Phone/Fax

Practice location:
  • Phone: 409-226-1888
  • Fax:
Mailing address:
  • Phone: 409-722-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ7188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: