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1316674880
RAFAEL LUIS FONSECA
PLANO, TX
NPI
1316674880
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1089259)
Enumeration Date
2022-08-04
Last Update Date
2022-11-03
Business Address
RAFAEL LUIS FONSECA FNP
2300 14TH ST STE 145
PLANO, TX 75074-6445
Phone number: 972-904-0812
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Mailing Address
RAFAEL LUIS FONSECA FNP
1100 GANNON DR
PLANO, TX 75025-2921
Phone number: 972-904-0812
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