Provider Demographics
NPI:1225366370
Name:DR. RAYMOND B. ACEBO
Entity Type:Organization
Organization Name:DR. RAYMOND B. ACEBO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:B
Authorized Official - Last Name:ACEBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-653-4541
Mailing Address - Street 1:2601 HOSPITAL BLVD
Mailing Address - Street 2:STE. #201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1815
Mailing Address - Country:US
Mailing Address - Phone:361-653-4541
Mailing Address - Fax:361-653-4543
Practice Address - Street 1:2601 HOSPITAL BLVD
Practice Address - Street 2:STE. #201
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1815
Practice Address - Country:US
Practice Address - Phone:361-653-4541
Practice Address - Fax:361-653-4543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty