Provider Demographics
NPI:1275723082
Name:RAPHA MEDICAL CARE P.A.
Entity Type:Organization
Organization Name:RAPHA MEDICAL CARE P.A.
Other - Org Name:RAPHA MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERGUS
Authorized Official - Middle Name:T
Authorized Official - Last Name:AKWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-551-6709
Mailing Address - Street 1:6901 MCCART AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-6377
Mailing Address - Country:US
Mailing Address - Phone:817-292-2011
Mailing Address - Fax:817-292-3691
Practice Address - Street 1:6901 MCCART AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-6377
Practice Address - Country:US
Practice Address - Phone:817-292-2011
Practice Address - Fax:817-292-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L7638261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care