Provider Demographics
NPI:1053355313
Name:RANGEL, LIONEL C (MD)
Entity type:Individual
Prefix:
First Name:LIONEL
Middle Name:C
Last Name:RANGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1626 MEDICAL CENTER DR STE 400
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1626 MEDICAL CENTER DR STE 400
Practice Address - Street 2:4TH FLOOR
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5000
Practice Address - Country:US
Practice Address - Phone:915-546-9200
Practice Address - Fax:915-546-9800
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM55438563Medicaid
TX143585103Medicaid
TX143585104Medicaid
TXTXB110781Medicare PIN
TX143585103Medicaid
TX143585104Medicaid