Provider Demographics
NPI:1467646885
Name:PHYSICIAN CARE & DIAGNOSTICS
Entity Type:Organization
Organization Name:PHYSICIAN CARE & DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAFLOR-WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-592-1115
Mailing Address - Street 1:705 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4630
Mailing Address - Country:US
Mailing Address - Phone:281-592-1115
Mailing Address - Fax:
Practice Address - Street 1:9889 BELLAIRE BLVD
Practice Address - Street 2:STE 123
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3463
Practice Address - Country:US
Practice Address - Phone:713-988-9388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty