1275723082 NPI number — RAPHA MEDICAL CARE P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275723082 NPI number — RAPHA MEDICAL CARE P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPHA MEDICAL CARE P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275723082
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6901 MCCART AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76133-6377
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-292-2011
Provider Business Mailing Address Fax Number:
817-292-3691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6901 MCCART AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76133-6377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-292-2011
Provider Business Practice Location Address Fax Number:
817-292-3691
Provider Enumeration Date:
07/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AKWAR
Authorized Official First Name:
FERGUS
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
682-551-6709

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  L7638 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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