Provider Demographics
NPI:1578612396
Name:RIOS, MARIA JAUREGUI (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:JAUREGUI
Last Name:RIOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:JAUREGUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5128 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2834
Mailing Address - Country:US
Mailing Address - Phone:956-631-3831
Mailing Address - Fax:956-631-5537
Practice Address - Street 1:5128 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2834
Practice Address - Country:US
Practice Address - Phone:956-631-3831
Practice Address - Fax:956-631-5537
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03514363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA03514OtherSTATE LICENSE
TX217466601Medicaid
TX217466601Medicaid