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General NPI Number Information
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NPI Number | 1568751790
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Entity Type | Individual
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Provider Name | RAUL A RAUDALES JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 6320 N LA CHOLLA BLVD STE 200
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City | TUCSON
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State | AZ
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Zip | 85741-3549
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Country | US
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Telephone | 520-382-8200
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Fax | 520-297-3505
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Provider Business Mailing Address
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Address Line | PO BOX 31630
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City | TUCSON
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State | AZ
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Zip | 85751-1630
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Country | US
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Telephone | 520-784-6200
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Fax | 520-784-6109
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 35.124202
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 74060
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License Number State | AZ
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