Individual
MR. PAUL RAYMOND GOORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 SHEEP SPRINGS WAY, JEMEZ PUEBLO, NM 87114
(505) 834-7413
(505) 834-7517
Mailing address
10001 COORS BYP NW, APT #1118, ALBUQUERQUE, NM 87114-4024
(505) 834-7413
(505) 834-7517
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
84-PA005
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91314
—
NM
Enumeration date
09/27/2006
Last updated
07/08/2007
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