Provider Demographics
NPI:1699214577
Name:HOUSTON, RALICA NINOVA (PA-C)
Entity Type:Individual
Prefix:
First Name:RALICA
Middle Name:NINOVA
Last Name:HOUSTON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:210-297-2244
Mailing Address - Fax:210-297-2257
Practice Address - Street 1:3903 WISEMAN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-681-0126
Practice Address - Fax:210-681-5228
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2019-01-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant