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Individual
ANA CLARISSA RAYGOZA
Active
Individual
ANA CLARISSA RAYGOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05804
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RM40
MEDICARE GROUP
TX
01
—
8L3648
PTAN
TX
Enumeration date
07/15/2008
Last updated
11/02/2009
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