Provider Demographics
NPI:1346124120
Name:RAPHAEL DIRECT PRIMARY CARE PLLC
Entity type:Organization
Organization Name:RAPHAEL DIRECT PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AVEGIYEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-296-3747
Mailing Address - Street 1:8106 VALDEMORILLO DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6025
Mailing Address - Country:US
Mailing Address - Phone:512-296-3747
Mailing Address - Fax:
Practice Address - Street 1:4722 EVERHART RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2740
Practice Address - Country:US
Practice Address - Phone:512-296-3747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center