Provider Demographics
NPI:1134889371
Name:RABBE, CLAYTON ANDREW (PA-C)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:ANDREW
Last Name:RABBE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 ESTES RANCH RD
Mailing Address - Street 2:
Mailing Address - City:BRUCEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76630-3351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 ESTES RANCH RD
Practice Address - Street 2:
Practice Address - City:BRUCEVILLE
Practice Address - State:TX
Practice Address - Zip Code:76630-3351
Practice Address - Country:US
Practice Address - Phone:254-716-2936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant