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General NPI Number Information
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NPI Number | 1447080197
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Entity Type | Individual
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Provider Name | MR. RAFAEL MAGANA JR.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2210 SUN COUNTRY DR
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City | EL PASO
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State | TX
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Zip | 79938-4644
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Country | US
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Telephone | 915-937-6601
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Fax |
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Provider Business Mailing Address
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Address Line | 12100 EASTLAKE BLVD
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City | EL PASO
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State | TX
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Zip | 79928-7813
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Country | US
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Telephone | 915-937-1850
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 122897
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License Number State | TX
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