Provider Demographics
NPI:1134353261
Name:STALEY, RALPH JR (FIRST ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:
Last Name:STALEY
Suffix:JR
Gender:M
Credentials:FIRST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1234 SONESTA LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2462
Mailing Address - Country:US
Mailing Address - Phone:210-254-7993
Mailing Address - Fax:210-499-4405
Practice Address - Street 1:1234 SONESTA LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-2462
Practice Address - Country:US
Practice Address - Phone:210-254-7993
Practice Address - Fax:210-499-4405
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant