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NPI Code Detail

MEDICARE: PAUL WILLIAM RAVA MPAS, PA-C

MEDICARE:   PAUL WILLIAM RAVA  MPAS, PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA13624TX
2171000000XMilitary Health Care Provider1158127VA

General Provider Information

NPI Number : 1659840957
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL WILLIAM RAVA MPAS, PA-C
Provider Business Mailing Address
First Line : 6448 CASPER RDG
Second Line :
City : EL PASO
State : TX
Zip : 79912-8129
Country : US
Telephone Number : 949-689-7402
Fax Number :
Provider Business Practice Location Address
First Line : 10765 KENWORTHY ST STE A
Second Line :
City : EL PASO
State : TX
Zip : 79924-1748
Country : US
Telephone Number : 915-308-2060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2018
Last Update Date : 05/15/2024

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Directions to “ PAUL WILLIAM RAVA MPAS, PA-C” Practice Location

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