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General NPI Number Information
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NPI Number | 1407133036
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Entity Type | Organization
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Legal Business Name | RAFAEL E. VALENZUELA, M.D.P.A.
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 720 E TIDWELL RD
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City | HOUSTON
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State | TX
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Zip | 77022-1822
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Country | US
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Telephone | 713-691-0035
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Fax | 713-691-2448
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Provider Business Mailing Address
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Address Line | 720 E TIDWELL RD
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City | HOUSTON
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State | TX
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Zip | 77022-1822
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Country | US
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Telephone | 713-691-0035
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Fax | 713-691-2448
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL ERNESTO VALENZUELA
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Credential | F7938
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Telephone | 713-691-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | F7948
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License Number State | TX
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