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General NPI Number Information
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NPI Number | 1093822140
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Entity Type | Organization
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Legal Business Name | RAYMOND P MUSSETT MD PLLC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 640 E BRAVO BLVD
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City | ROMA
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State | TX
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Zip | 78584
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Country | US
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Telephone | 956-849-2176
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Fax | 956-849-3439
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Provider Business Mailing Address
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Address Line | PO BOX 1120
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City | ROMA
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State | TX
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Zip | 78584
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Country | US
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Telephone | 956-849-2176
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Fax | 956-849-3439
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | RAYMOND P MUSSETT
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Credential | MD
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Telephone | 956-849-2176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TX
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