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General NPI Number Information
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NPI Number | 1467648881
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Entity Type | Individual
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Provider Name | MASSALA PRINCE REFFELL O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1309 E RIDGE RD STE 1
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City | MCALLEN
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State | TX
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Zip | 78503-1518
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Country | US
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Telephone | 956-631-8875
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Fax | 956-683-1502
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Provider Business Mailing Address
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Address Line | PO BOX 4830
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City | EDINBURG
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State | TX
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Zip | 78540-4830
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Country | US
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Telephone | 956-631-8875
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Fax | 956-683-1502
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 06876TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | 06876TG
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 06876TG
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License Number State | TX
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