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NPI 1720056609

NPI 1720056609 : RUDY WILBERT AROCHA OTHER : INGLESIDE, TX

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General NPI Number Information
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    NPI Number           |    1720056609
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    Entity Type          |    Individual 
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    Provider Name        |    RUDY WILBERT AROCHA OTHER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    BRANCH HEALTH CLINIC 327 CORAL SEA DR. SUITE 165
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    City                 |    INGLESIDE
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    State                |    TX
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    Zip                  |    78362
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    Country              |    US
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    Telephone            |    361-776-1107
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    108 W JANIN CIR 
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    City                 |    PORTLAND
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    State                |    TX
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    Zip                  |    78374-1414
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    Country              |    US
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    Telephone            |    361-776-1107
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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        |    1710I1002X
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    Taxonomy Name        |    Independent Duty Corpsman
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    License Number       |    
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    License Number State |    
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