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Individual
RAFAEL A MANGUAL
Active
Individual
RAFAEL A MANGUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
L0395
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010HX
BLUE CROSS BLUE SHIELD OF
TX
05
—
037596602
—
TX
05
—
046869603
—
TX
01
—
08019173
RAILROAD MEDICARE
TX
01
—
H27087
MERCY HEALTH PLANS
MO
Enumeration date
11/14/2005
Last updated
12/03/2015
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