1396790747 NPI number — RAUL RAMOS, M.D., FACS

Table of content: (NPI 1396790747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396790747 NPI number — RAUL RAMOS, M.D., FACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAUL RAMOS, M.D., FACS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1396790747
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 848813
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02284-8813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-1600
Provider Business Mailing Address Fax Number:
210-614-1606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
540 MADISON OAK DR
Provider Second Line Business Practice Location Address:
SUITE 370
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78258-3943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-1600
Provider Business Practice Location Address Fax Number:
210-614-1606
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAMOS
Authorized Official First Name:
RAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
210-614-1600

Provider Taxonomy Codes

  • Taxonomy code: 208C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 157186102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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