Basic Information
| Provider Information | |||||||||
| NPI: | 1740267764 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAIMONDO | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 PROVIDENCE DR | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767072261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2543134200 | ||||||||
| FaxNumber: | 2543134531 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 BELLMEAD DRIVE | ||||||||
| Address2: | |||||||||
| City: | BELLMEAD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2543135400 | ||||||||
| FaxNumber: | 2543134531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2005 | ||||||||
| LastUpdateDate: | 04/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | M2027 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.