Provider Demographics
NPI:1942313218
Name:AMARO, RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:AMARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:1411 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2778
Practice Address - Country:US
Practice Address - Phone:512-341-0900
Practice Address - Fax:512-341-2895
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1262174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00147528OtherMEDICARE RAILROAD
TX083176001Medicaid
TX8F6931OtherBCBS OF TEXAS
TX1942331335OtherGROUP NPI
TX7606217OtherAETNA US HEALTHCARE
TX148191302Medicaid
TX148191302Medicaid
TXH45705Medicare UPIN