Provider Demographics
NPI:1770057739
Name:RAZEQ, REEM (PA)
Entity type:Individual
Prefix:MRS
First Name:REEM
Middle Name:
Last Name:RAZEQ
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3503 PAESANOS PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1225
Mailing Address - Country:US
Mailing Address - Phone:210-589-7386
Mailing Address - Fax:
Practice Address - Street 1:3503 PAESANOS PKWY STE 201
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1225
Practice Address - Country:US
Practice Address - Phone:210-504-3650
Practice Address - Fax:210-519-3045
Is Sole Proprietor?:No
Enumeration Date:2019-01-13
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA12334363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant