Provider Demographics
NPI:1326084211
Name:RAGLIN, MICHELE B (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:B
Last Name:RAGLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:B
Other - Last Name:IBANEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3434 SARATOGA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-5822
Mailing Address - Country:US
Mailing Address - Phone:361-985-9355
Mailing Address - Fax:361-992-3458
Practice Address - Street 1:3434 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-5822
Practice Address - Country:US
Practice Address - Phone:361-985-9355
Practice Address - Fax:361-992-3458
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0290207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045447203Medicaid
TX8AD410OtherBLUE CROSS
TX8F6211Medicare PIN
TX045447203Medicaid