Provider Demographics
NPI:1740441104
Name:IBARRA, RAFAEL ANDRES (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANDRES
Last Name:IBARRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1250 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:BLDG. ONE, SUITE 500
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6446
Mailing Address - Country:US
Mailing Address - Phone:512-402-6233
Mailing Address - Fax:512-903-1053
Practice Address - Street 1:1250 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:BLDG. ONE, SUITE 500
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6446
Practice Address - Country:US
Practice Address - Phone:512-402-6233
Practice Address - Fax:512-903-1053
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2013-09-27
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Provider Licenses
StateLicense IDTaxonomies
TXP7650207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine