Provider Demographics
NPI:1538335997
Name:MONCAYO, RAFAEL EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:EDUARDO
Last Name:MONCAYO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:2750 FM 1463 RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6887
Practice Address - Country:US
Practice Address - Phone:832-658-3010
Practice Address - Fax:281-392-2622
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2024-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN1781207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7308380OtherAETNA
TX8CG328OtherBCBS OF TX
TXTXB108864Medicare PIN