Provider Demographics
NPI:1255406930
Name:BORGES, RAFAEL G (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:G
Last Name:BORGES
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 1:13626 VETERANS MEMORIAL DR STE F
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1053
Mailing Address - Country:US
Mailing Address - Phone:281-580-8880
Mailing Address - Fax:281-580-8881
Practice Address - Street 1:13626 VETERANS MEMORIAL DR STE F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1053
Practice Address - Country:US
Practice Address - Phone:281-580-8880
Practice Address - Fax:281-580-8881
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042969802Medicaid
TX042969802Medicaid
TX00615QMedicare ID - Type Unspecified