Provider Demographics
NPI:1386619468
Name:BAKER, WILLARD ROBERT JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:ROBERT
Last Name:BAKER
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1000 E VERMONT AVE
Mailing Address - Street 2:APT. 1103
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1717
Mailing Address - Country:US
Mailing Address - Phone:955-926-5129
Mailing Address - Fax:956-686-2936
Practice Address - Street 1:110 E SAVANNAH AVE
Practice Address - Street 2:SUITE 101A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1241
Practice Address - Country:US
Practice Address - Phone:956-686-4040
Practice Address - Fax:956-686-2936
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXPA00211363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical