| Rc Raley Professional Association | |
|
2301 W North Loop Blvd Austin TX 78756-2326 | |
| (512) 452-2506 | |
| Not Available |
| Full Name | Rc Raley Professional Association |
|---|---|
| Speciality | Family Medicine |
| Location | 2301 W North Loop Blvd, Austin, Texas |
| Authorized Official Name and Position | Robert C Raley (PRESIDENT) |
| Authorized Official Contact | 5124522506 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rc Raley Professional Association 807 Stark St Austin TX 78756-1508 Ph: (512) 452-2506 | Rc Raley Professional Association 2301 W North Loop Blvd Austin TX 78756-2326 Ph: (512) 452-2506 |
| NPI Number | 1407168552 |
|---|---|
| Provider Enumeration Date | 07/06/2010 |
| Last Update Date | 04/03/2024 |
| Medicare PECOS PAC ID | 7214122555 |
|---|---|
| Medicare Enrollment ID | O20101111000903 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407168552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 364SA2200X | Clinical Nurse Specialist - Adult Health | (* (Not Available)) | Secondary |
| Provider Name | Robert C Raley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154460590 PECOS PAC ID: 8123213469 Enrollment ID: I20101111000919 |
| Provider Name | Aline Zeringue |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1750505020 PECOS PAC ID: 5799002911 Enrollment ID: I20150327001840 |
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