MEDICARE: REYNALDO RANGEL SR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	38481	TX

General Provider Information

NPI Number	:	1437519287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REYNALDO RANGEL SR.

Provider Business Mailing Address
First Line	:	2008 W PALMA VISTA DR
Second Line	:
City	:	PALMVIEW
State	:	TX
Zip	:	78572-2151
Country	:	US
Telephone Number	:	956-583-0580
Fax Number	:	956-583-0809

Provider Business Practice Location Address
First Line	:	2008 W PALMA VISTA DR
Second Line	:
City	:	PALMVIEW
State	:	TX
Zip	:	78572-2151
Country	:	US
Telephone Number	:	956-583-0580
Fax Number	:	956-583-0809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	03/07/2016

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