Provider Demographics
NPI:1003188103
Name:R FAMILY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:R FAMILY MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-533-0257
Mailing Address - Street 1:3110 NOGALITOS
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-2336
Mailing Address - Country:US
Mailing Address - Phone:210-533-0257
Mailing Address - Fax:210-531-9488
Practice Address - Street 1:3110 NOGALITOS
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78225-2336
Practice Address - Country:US
Practice Address - Phone:210-533-0257
Practice Address - Fax:210-531-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN7743OtherMEDICAL LICENCE-FAMILY MEDICINE
TX217279301Medicaid
TXTXB110331OtherMEDICARE PROVIDER NUMBER