Gooris, Paul Raymond

Gooris, Paul Raymond is an individual health care provider with primary practice located at 110 Sheep Springs Way , Jemez Pueblo NM 87114. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gooris, Paul Raymond can be contacted via phone (505) 834-7413.

Contact Information

Primary practice address
110 Sheep Springs Way Jemez Pueblo NM 87114
Fax: (505) 834-7517
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 84-PA005 New Mexico

Profile Details

NPI number 1013008150
LBN Legal business name Gooris, Paul Raymond
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013008150 NPPES
New Mexico MEDICAID 91314

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