Individual
RAFAEL ALBERTO MIMBELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4770 N EXPRESSWAY # 83, SUITE 102, BROWNSVILLE, TX 78526-4165
(956) 350-0779
(956) 350-3006
Mailing address
PO BOX 5718, BROWNSVILLE, TX 78523-5718
(956) 350-0779
(956) 350-3006
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
K1878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110734402
—
TX
01
—
614370
MEDICARE
TX
Enumeration date
08/23/2006
Last updated
08/31/2015
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