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Mr. Fernando Raudales

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NPI Number Detailed Information

Provider Information:

Name: Mr. Fernando Raudales
Gender: M
Provider License Number If Given: G9646

NPI Information:

NPI: 1801880307
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 6/8/2015

Provider Business Mailing Address:

Address: 1310 MURCHISON DRIVE SUITE 100
El Paso, TX 79902
Phone Number: 9154554500
Fax Number: 9155469430

Provider Business Practice Location Address:

Address: 1310 MURCHISON DRIVE SUITE 100
El Paso, TX 79902
Phone Number: 9154554500
Fax Number: 9155444572

Provider Taxonomy:

Primary: 207RN0300X
Secondary (if any):
State: TX

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