Organization Active NPI

Maverick County Rural Radiologists P a

  • Diagnostic Radiology Physician
  • Eagle Pass, TX
National Provider Identifier
1437117181
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MAVERICK COUNTY RURAL RADIOLOGISTS P A
Practice address
3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893
Phone
(830) 773-5321
NPI assigned
May 3, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Abraham Daniel Rafie, MDNPI 1053596924
Title
MD/Owner
Phone
(913) 777-1765

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

3333 N Foster Maldonado Blvd
Eagle Pass, TX 78852-5893

Mailing address

PO Box 9730
Longview, TX 75608-9730
Phone (903) 663-4800

Other identifiers 1

IdentifierTypeStateIssuer
081212501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KS, MD, AL, NY, MO, CA, GA, FL, AZ10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20040826000884 TX Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 13 practitioners
Practice locations: New Braunfels, TX; Eagle Pass, TX
O20190214000472 KS Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Lenexa, KS
O20230711004447 MD Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, MD
O20230717002074 AL Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Midland City, AL
O20230720001559 NY Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Smithtown, NY
O20230726003677 MO Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, MO; Springfield, MO
O20230829003298 CA Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington Beach, CA
O20231213002297 GA Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Savannah, GA
O20240119000579 FL Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Clewiston, FL
O20240405002060 AZ Part B Supplier - Clinic/Group Practice 0648245415 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

345 S Adams St
Ste 7
Eagle Pass, TX 78852
Phone (830) 757-7560

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1437117181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9730",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756089730",
            "telephone_number": "903-663-4800",
            "fax_number": "903-663-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N FOSTER MALDONADO BLVD",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788525893",
            "telephone_number": "830-773-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK COUNTY RURAL RADIOLOGISTS P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "RAFIE",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "913-777-1765",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081212501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.