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General NPI Number Information
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NPI Number | 1417610569
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Entity Type | Individual
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Provider Name | RAFAEL ANGEL UZCATEGUI PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 2715 W TRENTON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3433
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Country | US
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Telephone | 956-618-4878
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 E 1ST ST APT 21
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City | MISSION
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State | TX
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Zip | 78572-0025
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Country | US
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Telephone | 786-702-8561
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1102-P.A.
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License Number State | PR
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