Individual
JOHN RAYMOND ERNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4204 E STAN SCHLUETER LOOP, KILLEEN, TX 76542-8352
(916) 742-3215
Mailing address
170 DEEP WOOD DR STE 105, ROUND ROCK, TX 78681-4949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1108109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440680840
—
TX
Enumeration date
09/27/2012
Last updated
12/28/2023
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