Provider Demographics
NPI:1790806750
Name:RAUL MIRELES MD PA
Entity Type:Organization
Organization Name:RAUL MIRELES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR UROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRELES
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:956-722-5221
Mailing Address - Street 1:PO BOX 450051
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0001
Mailing Address - Country:US
Mailing Address - Phone:956-722-5221
Mailing Address - Fax:956-717-2910
Practice Address - Street 1:7210 MCPHERSON RD STE 210
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6505
Practice Address - Country:US
Practice Address - Phone:956-722-5221
Practice Address - Fax:956-717-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty