Individual
MR. WILLIE RAYMOND VASQUEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2389 HIGHWAY 28 E, PINEVILLE, LA 71360-5607
(318) 487-1925
Mailing address
1235 HEYMAN LN, ALEXANDRIA, LA 71303-2909
(318) 308-3834
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.A10563
LA
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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