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General NPI Number Information
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NPI Number | 1255312245
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Entity Type | Individual
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Provider Name | RAUL SEPULVEDA MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 17270 RED OAK DR SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77090-2632
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Country | US
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Telephone | 281-440-6960
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Fax | 281-440-6205
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Provider Business Mailing Address
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Address Line | PO BOX 4356 DEPT 665
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City | HOUSTON
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State | TX
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Zip | 77210-4356
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Country | US
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Telephone | 281-440-6960
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Fax | 281-440-6205
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | D9284
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License Number State | TX
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