Provider Demographics
NPI:1982013199
Name:YEPEZ, RAUDE (CSFA)
Entity Type:Individual
Prefix:
First Name:RAUDE
Middle Name:
Last Name:YEPEZ
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 MARISA ALEXIS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4693
Mailing Address - Country:US
Mailing Address - Phone:713-906-6544
Mailing Address - Fax:
Practice Address - Street 1:7501 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1938
Practice Address - Country:US
Practice Address - Phone:713-375-7000
Practice Address - Fax:713-375-7205
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO151336246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant