Provider Demographics
NPI:1811989460
Name:RAPP, GARY STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEPHEN
Last Name:RAPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 S ALTO MESA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4426
Mailing Address - Country:US
Mailing Address - Phone:915-833-6631
Mailing Address - Fax:915-833-6618
Practice Address - Street 1:2001 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3320
Practice Address - Country:US
Practice Address - Phone:915-833-6631
Practice Address - Fax:915-833-6618
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD61372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83R585Medicare ID - Type Unspecified
TXE14659Medicare UPIN