Individual
RAY RENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-2485
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-2485
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1046213
—
363AS0400X
Surgical Physician Assistant
Primary
PA09738
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA09738
TEXAS MEDICAL BOARD
TX
Enumeration date
03/17/2006
Last updated
06/01/2023
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