Healthcare Provider Details

I. General information

NPI: 1790055994
Provider Name (Legal Business Name): RAYMOND H HON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2304 N CARNATION LN
PHARR TX
78577-2449
US

IV. Provider business mailing address

2304 N CARNATION LN
PHARR TX
78577-2449
US

V. Phone/Fax

Practice location:
  • Phone: 909-559-2132
  • Fax:
Mailing address:
  • Phone: 909-559-2132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP126557
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: