Provider Demographics
NPI:1437519287
Name:RANGEL, REYNALDO SR
Entity Type:Individual
Prefix:
First Name:REYNALDO
Middle Name:
Last Name:RANGEL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 W PALMA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2151
Mailing Address - Country:US
Mailing Address - Phone:956-583-0580
Mailing Address - Fax:956-583-0809
Practice Address - Street 1:2008 W PALMA VISTA DR
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-2151
Practice Address - Country:US
Practice Address - Phone:956-583-0580
Practice Address - Fax:956-583-0809
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist