Provider Demographics
NPI:1568713691
Name:BARAJAS, RICARDO JR (ACUPUNTURE)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:BARAJAS
Suffix:JR
Gender:M
Credentials:ACUPUNTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 JUANCHIDO LN
Mailing Address - Street 2:
Mailing Address - City:YSLETA DEL SUR PUEBLO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-6832
Mailing Address - Country:US
Mailing Address - Phone:915-858-1076
Mailing Address - Fax:915-858-2367
Practice Address - Street 1:9314 JUANCHIDO LN
Practice Address - Street 2:
Practice Address - City:YSLETA DEL SUR PUEBLO
Practice Address - State:TX
Practice Address - Zip Code:79907-6832
Practice Address - Country:US
Practice Address - Phone:915-858-1076
Practice Address - Fax:915-858-2367
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00737171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist