Individual
DR. RAUL MAURICIO LLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Mailing address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
N5816
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299654801
—
TX
01
—
8DC265
BCBSTX
TX
Enumeration date
07/20/2007
Last updated
04/27/2020
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