Provider Demographics
NPI:1679996391
Name:RAMIREZ, EDNA (SLP)
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 MATA BLVD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2308
Mailing Address - Country:US
Mailing Address - Phone:956-519-2700
Mailing Address - Fax:
Practice Address - Street 1:2504 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3348
Practice Address - Country:US
Practice Address - Phone:956-519-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108310OtherSTATE BOARD FOR EXAMINERS FOR SPEECH & LANGUAGE PATHOLOGY AND AUDIOLOGY