Provider Demographics
NPI:1104037480
Name:RAUL LEDESMA M.D. P.A.
Entity Type:Organization
Organization Name:RAUL LEDESMA M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LEDESMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-994-0026
Mailing Address - Street 1:PO BOX 2378
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2378
Mailing Address - Country:US
Mailing Address - Phone:956-994-0026
Mailing Address - Fax:956-994-0032
Practice Address - Street 1:5508 N 1ST ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2212
Practice Address - Country:US
Practice Address - Phone:956-994-0026
Practice Address - Fax:956-994-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5429207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6941Medicare PIN
TXG56589Medicare UPIN