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Individual

RAFAEL MEDRANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4301 N MESA ST, STE 101, EL PASO, TX 79902-1121
(915) 542-2352
(915) 593-8559
Mailing address
7814 GATEWAY BLVD E, EL PASO, TX 79915-1815
(915) 542-2352
(915) 593-8559

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H3914
TX
207RC0000X
Cardiovascular Disease Physician
Primary
H3914
TX
207UN0901X
Nuclear Cardiology Physician
H3914
TX
2085B0100X
Body Imaging Physician
H3914
TX
2085R0202X
Diagnostic Radiology Physician
H3914
TX
2085R0204X
Vascular & Interventional Radiology Physician
H3914
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043210792
NPI
TX
05
106013901
TX
01
88T972
BX
TX
Enumeration date
07/22/2005
Last updated
01/27/2022
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