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Individual
MR. JUAN JOSE CARRALES
Active
Individual
MR. JUAN JOSE CARRALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1132749
NCCPA CERTIFICATION
—
01
—
PA10556
TX MEDICAL BOARD - LICENSE
TX
Enumeration date
08/26/2016
Last updated
02/16/2022
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