Provider Demographics
NPI:1164052213
Name:TORRECAMPO, RAYMOND (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:TORRECAMPO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S DARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7447
Mailing Address - Country:US
Mailing Address - Phone:915-239-2955
Mailing Address - Fax:915-249-6155
Practice Address - Street 1:201 S DARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7447
Practice Address - Country:US
Practice Address - Phone:915-239-2955
Practice Address - Fax:915-249-6155
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14805363AM0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program