Provider Demographics
NPI:1699214577
Name:HOUSTON, RALICA NINOVA (PA-C)
Entity type:Individual
Prefix:
First Name:RALICA
Middle Name:NINOVA
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3011 W LOOP 1604 N STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3901
Mailing Address - Country:US
Mailing Address - Phone:210-681-0126
Mailing Address - Fax:210-681-0138
Practice Address - Street 1:3011 W LOOP 1604 N STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3901
Practice Address - Country:US
Practice Address - Phone:210-681-0126
Practice Address - Fax:210-681-0138
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-13
Last Update Date:2024-08-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant