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General NPI Number Information
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NPI Number | 1164456943
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Entity Type | Individual
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Provider Name | RAUL ADRIAN PENA MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 1400 E RIDGE RD STE 10
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City | MCALLEN
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State | TX
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Zip | 78503-1536
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Country | US
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Telephone | 956-661-8733
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Fax | 956-661-8724
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Provider Business Mailing Address
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Address Line | 1400 E RIDGE RD STE 10
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City | MCALLEN
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State | TX
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Zip | 78503-1536
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Country | US
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Telephone | 956-661-8733
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Fax | 956-661-8724
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | L0504
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License Number State | TX
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