Provider Demographics
NPI:1508844028
Name:WALKER, RAYMOND B (CRNA)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:B
Last Name:WALKER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3328
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:605 E VIOLET AVE
Practice Address - Street 2:STE 6
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2469
Practice Address - Country:US
Practice Address - Phone:956-682-4151
Practice Address - Fax:956-682-4154
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX656396367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85257UOtherBCBS
TX002529802Medicaid
TX85257UOtherBCBS
TX002529802Medicaid