Provider Demographics
NPI:1952533770
Name:RAFAEL J DELIZ MD PA
Entity Type:Organization
Organization Name:RAFAEL J DELIZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-220-4597
Mailing Address - Street 1:9114 MCPHERSON RD
Mailing Address - Street 2:STE 2509
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6511
Mailing Address - Country:US
Mailing Address - Phone:956-795-1887
Mailing Address - Fax:956-795-1476
Practice Address - Street 1:9114 MC PHERSON RD
Practice Address - Street 2:STE 2509
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6511
Practice Address - Country:US
Practice Address - Phone:956-795-1887
Practice Address - Fax:956-795-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2057207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11136884OtherCAQH