Provider Demographics
NPI:1538051024
Name:STA. JUANA, PAUL ANGELO (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ANGELO
Last Name:STA. JUANA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 SHALOM
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9687
Mailing Address - Country:US
Mailing Address - Phone:210-763-3887
Mailing Address - Fax:
Practice Address - Street 1:501 E BUSINESS HWY 83
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-2526
Practice Address - Country:US
Practice Address - Phone:210-763-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor