Individual
JESUS RANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.C.A., BC-H.I.S.
Contact information
Practice address
1407 LAGO TRL STE 100, LONGVIEW, TX 75604-2740
(903) 247-3444
(903) 247-3853
Mailing address
925 W LOOP 281, LONGVIEW, TX 75604-2918
(903) 247-3444
(903) 247-3853
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
1164
LA
237700000X
Hearing Instrument Specialist
Primary
50606
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1762338-01
—
TX
01
—
531646
BLUE CROSS BLUE SHIELD
TX
01
—
610593600
DOL-OWCP (WORKERS COMP)
TX
Enumeration date
03/26/2007
Last updated
03/14/2018
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