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General NPI Number Information
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NPI Number | 1003933649
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Entity Type | Individual
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Provider Name | JESUS RANGEL A.C.A., BC-H.I.S.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 1407 LAGO TRL STE 100
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City | LONGVIEW
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State | TX
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Zip | 75604-2740
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Country | US
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Telephone | 903-247-3444
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Fax | 903-247-3853
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Provider Business Mailing Address
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Address Line | 925 W LOOP 281
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City | LONGVIEW
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State | TX
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Zip | 75604-2918
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Country | US
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Telephone | 903-247-3444
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Fax | 903-247-3853
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 1164
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 50606
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License Number State | TX
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