Individual
RAFAEL A MANGUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 795-8100
(956) 718-6294
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 795-8100
(956) 718-6294
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
L0395
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010HX
BLUE CROSS BLUE SHIELD OF
TX
05
—
037596602
—
TX
05
—
046869603
—
TX
01
—
08019173
RAILROAD MEDICARE
TX
01
—
H27087
MERCY HEALTH PLANS
MO
Enumeration date
11/14/2005
Last updated
12/03/2015
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