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Organization

RAFAEL E. VALENZUELA, M.D.P.A.

Active
Parent organization
RAFAEL E. VALENZUELA, M.D.P.A.
Other names
EDWARD INDUSTRIAL MEDICAL CLINIC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RAFAEL E. VALENZUELA, M.D.P.A.
Authorized official
DR. RAFAEL ERNESTO VALENZUELA F7938 (PRESIDENT)
(713) 691-0035
Entity
Organization

Contact information

Practice address
720 E TIDWELL RD, HOUSTON, TX 77022-1822
(713) 691-0035
(713) 691-2448
Mailing address
720 E TIDWELL RD, HOUSTON, TX 77022-1822
(713) 691-0035
(713) 691-2448

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
F7948
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
091998701
TX
Enumeration date
11/10/2011
Last updated
12/02/2011
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