Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD.014388 | LA |
NPI | 1134271448 |
---|---|
Provider Name | Dr. Raul Enrique Varela |
First Address | Irving, TX 75038-3813 |
Second Address | Lake Charles, LA 70601-5864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 17/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1175722 | (05) | LA |
B65815 | (02) | LA |