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General NPI Number Information
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NPI Number | 1306395793
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Entity Type | Organization
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Legal Business Name | RAFAEL A LUGO MD PA
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 17189 INTERSTATE 45 S STE 275
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City | SHENANDOAH
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State | TX
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Zip | 77385-3326
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Country | US
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Telephone | 832-377-5846
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Fax | 888-416-9722
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Provider Business Mailing Address
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Address Line | 10800 GOSLING RD UNIT 131330
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City | SPRING
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State | TX
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Zip | 77393-4064
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Country | US
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Telephone | 832-656-8465
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Fax | 888-416-9722
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. RAFAEL A LUGO
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Credential | MD
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Telephone | 832-656-8465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | K8309
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License Number State | TX
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