Provider Demographics
NPI:1265540959
Name:RAUL E. GAONA, SR, M.D., P.A.
Entity type:Organization
Organization Name:RAUL E. GAONA, SR, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:EFRAIN
Authorized Official - Last Name:GAONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-927-1472
Mailing Address - Street 1:98 BRIGGS ST
Mailing Address - Street 2:SUITE 900B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1286
Mailing Address - Country:US
Mailing Address - Phone:210-927-1472
Mailing Address - Fax:210-921-1212
Practice Address - Street 1:98 BRIGGS ST
Practice Address - Street 2:SUITE 900B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1286
Practice Address - Country:US
Practice Address - Phone:210-927-1472
Practice Address - Fax:210-921-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty