Basic Information
| Provider Information | |||||||||
| NPI: | 1013255470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEBRES | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 650859, DEPT. 710 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752650859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097222222 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3737 RED BLUFF RD STE 150 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775033307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4092261888 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2013 | ||||||||
| LastUpdateDate: | 11/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Q7188 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.