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Individual
RAPHAEL JOSY MATTAMAL
Active
Individual
RAPHAEL JOSY MATTAMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
45997
TX
208000000X
Pediatrics Physician
Primary
R4092
TX
390200000X
Student in an Organized Health Care Education/Training Program
582589
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200725100A
—
OK
05
—
374825301
—
TX
05
—
374825302
—
TX
05
—
73172511
—
NM
Enumeration date
04/23/2014
Last updated
02/23/2018
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