Provider Demographics
NPI:1356384259
Name:GAONA, RAUL EFRAIN SR (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:EFRAIN
Last Name:GAONA
Suffix:SR
Gender:M
Credentials:MD
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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
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-01-30
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Provider Licenses
StateLicense IDTaxonomies
TXD4124207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110092233OtherRAILROAD MEDICARE
TX127494604Medicaid
TXB22867Medicare UPIN
TX127494604Medicaid