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General NPI Number Information
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NPI Number | 1407808199
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Entity Type | Organization
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Legal Business Name | RAFAEL M. DE LA CRUZ MD
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 44 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6258
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Country | US
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Telephone | 956-544-2420
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Fax | 956-544-2879
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Provider Business Mailing Address
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Address Line | 44 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6258
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Country | US
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Telephone | 956-544-2420
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Fax | 956-544-2879
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAFAEL MARCOS DE LA CRUZ
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Credential | MD
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Telephone | 956-544-2420
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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 | D3726
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License Number State | TX
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