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General NPI Number Information
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NPI Number | 1609910009
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Entity Type | Individual
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Provider Name | TAL R RAPHAELI MD
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Gender | Male
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Dates
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Enumeration Date | 02/18/2007
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1125 CYPRESS STATION DR STE G-3
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City | HOUSTON
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State | TX
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Zip | 77090-3055
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Country | US
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Telephone | 281-583-1300
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Fax | 281-583-1303
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Provider Business Mailing Address
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Address Line | 1125 CYPRESS STATION DR STE G-3
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City | HOUSTON
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State | TX
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Zip | 77090-3055
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Country | US
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Telephone | 281-583-1300
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | P1919
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License Number State | TX
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