Provider Demographics
NPI:1306453139
Name:HENRY, RAFEL DONNELL
Entity type:Individual
Prefix:MR
First Name:RAFEL
Middle Name:DONNELL
Last Name:HENRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 RIVER POINTE DR APT 722
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2913
Mailing Address - Country:US
Mailing Address - Phone:254-644-3186
Mailing Address - Fax:
Practice Address - Street 1:2621 N WOODLOCH ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385-8581
Practice Address - Country:US
Practice Address - Phone:254-644-3186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management