1174765572 NPI number — DR. RAMIRO DE LOS SANTOS M.D.

Table of content: DR. RAMIRO DE LOS SANTOS M.D. (NPI 1174765572)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174765572 NPI number — DR. RAMIRO DE LOS SANTOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE LOS SANTOS
Provider First Name:
RAMIRO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174765572
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
580 HILLCREST BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAGLE PASS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78852-4328
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-776-4948
Provider Business Mailing Address Fax Number:
830-757-8622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 UNIVERSITY OF NEW MEXICO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87131-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-6225
Provider Business Practice Location Address Fax Number:
505-272-5184
Provider Enumeration Date:
03/31/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)