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General NPI Number Information
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NPI Number | 1235132796
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Entity Type | Individual
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Provider Name | RAUL ERNESTO LOAISIGA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 09/28/2015
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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 NORTH EXPRESSWAY 77/83 SUITE 206
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4780
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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 |
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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 | 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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