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General NPI Number Information
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NPI Number | 1740441104
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Entity Type | Individual
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Provider Name | RAFAEL ANDRES IBARRA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 1250 S CAPITAL OF TEXAS HWY BLDG. ONE, SUITE 500
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-6446
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Country | US
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Telephone | 512-402-6233
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Fax | 512-903-1053
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Provider Business Mailing Address
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Address Line | 1250 S CAPITAL OF TEXAS HWY BLDG. ONE, SUITE 500
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-6446
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Country | US
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Telephone | 512-402-6233
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Fax | 512-903-1053
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | P7650
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License Number State | TX
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