Provider Demographics
NPI:1053459750
Name:RAMIREZ, RAUL (MD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 SETON PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6182
Mailing Address - Country:US
Mailing Address - Phone:512-720-6044
Mailing Address - Fax:512-674-0415
Practice Address - Street 1:1180 SETON PKWY STE 260
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6182
Practice Address - Country:US
Practice Address - Phone:512-720-6044
Practice Address - Fax:512-674-0415
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224650207R00000X
TXN2257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287827403Medicaid
TX287827404Medicaid
TX287827402Medicaid
TX287827405Medicaid
TX287827405Medicaid
TXTXB157540Medicare PIN
TXTXB152926Medicare PIN
TXP01154784Medicare PIN
TX287827402Medicaid
TXP01193571Medicare PIN