Organization
FAMILY MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL G BORGES MD (DOCTOR)
(281) 880-9710
Entity
Organization
Contact information
Practice address
17203 RED OAK DR, SUITE 201, HOUSTON, TX 77090-2640
(281) 880-9710
(281) 880-9711
Mailing address
PO BOX 11220, HOUSTON, TX 77293-1220
(281) 880-9710
(281) 880-9711
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
K9230
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042969802
—
TX
01
—
8AJ811
B/C B/S OF TEXAS
TX
01
—
TXB110824
MEDICARE GROUP PTAN
TX
Enumeration date
11/27/2007
Last updated
08/21/2013
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