Provider Demographics
NPI:1881621365
Name:BARREDA, RAUL JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:BARREDA
Suffix:JR
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:PO BOX 2975
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2975
Mailing Address - Country:US
Mailing Address - Phone:956-362-8170
Mailing Address - Fax:956-362-8168
Practice Address - Street 1:1100 E DOVE AVE STE 300
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4682
Practice Address - Country:US
Practice Address - Phone:956-362-8170
Practice Address - Fax:956-362-8168
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM34632086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K9033OtherBCBS
TX184481303Medicaid
TXP00361474OtherRAILROAD
TX8X7929OtherBCBS
TX184480302Medicaid
TX184481305Medicaid
TX0034TWOtherBCBS
TX164184701Medicaid
TX184481304Medicaid
TXP00933302OtherRAILROAD
TX8J0673Medicare PIN
TXTXB110641Medicare PIN
TX8F23719Medicare PIN
TX8K9033OtherBCBS
TX0034TWOtherBCBS