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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 |
