Provider Demographics
NPI:1609028612
Name:RAFOLS, RAFAEL J (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:J
Last Name:RAFOLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SANTA LAURA
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7977
Mailing Address - Country:US
Mailing Address - Phone:956-627-4796
Mailing Address - Fax:866-221-2183
Practice Address - Street 1:5509 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5563
Practice Address - Country:US
Practice Address - Phone:956-362-5525
Practice Address - Fax:956-362-5530
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX290522601Medicaid