Provider Demographics
NPI:1083720833
Name:VIRGINIA A. RAUTH, M.D., P.A.
Entity Type:Organization
Organization Name:VIRGINIA A. RAUTH, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-789-4071
Mailing Address - Street 1:PO BOX 53233
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-3233
Mailing Address - Country:US
Mailing Address - Phone:806-789-4071
Mailing Address - Fax:
Practice Address - Street 1:8220 MEMPHIS AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2612
Practice Address - Country:US
Practice Address - Phone:806-789-4071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8837174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID#
TX=========OtherTAX ID#
TXB25805Medicare UPIN