Provider Demographics
NPI:1174277198
Name:BARRERA, LUIS DAMIAN (PA-C)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:DAMIAN
Last Name:BARRERA
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:PO BOX 4830
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-4830
Mailing Address - Country:US
Mailing Address - Phone:956-631-8875
Mailing Address - Fax:956-683-1502
Practice Address - Street 1:1309 E RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1518
Practice Address - Country:US
Practice Address - Phone:956-631-8875
Practice Address - Fax:956-683-1502
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15581363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant