Provider Demographics
NPI:1417610569
Name:UZCATEGUI, RAFAEL ANGEL (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANGEL
Last Name:UZCATEGUI
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 E 1ST ST APT 21
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-0025
Mailing Address - Country:US
Mailing Address - Phone:786-702-8561
Mailing Address - Fax:
Practice Address - Street 1:2715 W TRENTON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3433
Practice Address - Country:US
Practice Address - Phone:956-618-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1102-P.A.363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant