Provider Demographics
NPI:1891006763
Name:ARAYA, REDIET B (PAC)
Entity Type:Individual
Prefix:MR
First Name:REDIET
Middle Name:B
Last Name:ARAYA
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
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Mailing Address - Street 1:6245 RENWICK DR APT 4202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3803
Mailing Address - Country:US
Mailing Address - Phone:562-310-1270
Mailing Address - Fax:713-453-9402
Practice Address - Street 1:13415 WOODFOREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2922
Practice Address - Country:US
Practice Address - Phone:713-453-9400
Practice Address - Fax:713-453-9402
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20852363AM0700X
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical