Provider Demographics
NPI:1467657155
Name:RAFF, GARY (BS, RT(R), RCIS)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:RAFF
Suffix:
Gender:M
Credentials:BS, RT(R), RCIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 SADDLE RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7267
Mailing Address - Country:US
Mailing Address - Phone:325-949-7599
Mailing Address - Fax:
Practice Address - Street 1:5901 BROKEN SOUND PKWY NW
Practice Address - Street 2:STE. 500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
000520442471C1101X
3056742471C3402X
TX265142471C3402X
FLCRT-726382471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology
Not Answered2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography