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General NPI Number Information
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NPI Number | 1114162492
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Entity Type | Organization
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Legal Business Name | RAUL ERNESTO LOAISIGA MD PA
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 4770 N EXPRESSWAY # 7783 STE 206
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4120
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Country | US
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Telephone | 956-350-5500
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Fax | 956-350-4965
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Provider Business Mailing Address
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Address Line | 4770 N EXPRESSWAY STE. 206
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4165
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Country | US
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Telephone | 956-350-5500
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Fax | 956-350-4965
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAUL ERNESTO LOAISIGA
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Credential | MD
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Telephone | 956-350-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L0383
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License Number State | TX
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