Provider Demographics
NPI:1043462609
Name:RAFAEL YARIHUAMAN, ALDO ELMER (MD)
Entity Type:Individual
Prefix:MR
First Name:ALDO
Middle Name:ELMER
Last Name:RAFAEL YARIHUAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:ALDO
Other - Middle Name:ELMER
Other - Last Name:RAFAEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:621 N HALL ST STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1307
Practice Address - Country:US
Practice Address - Phone:469-822-7760
Practice Address - Fax:469-800-7770
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7335204F00000X, 208G00000X
OH35.099738208G00000X
ZZ18881208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery