Provider Demographics
NPI:1023013828
Name:RAMON, VICTOR J (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:J
Last Name:RAMON
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 1:4024 BRYN MAWR DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-7031
Mailing Address - Country:US
Mailing Address - Phone:214-370-4000
Mailing Address - Fax:
Practice Address - Street 1:712 N WASHINGTON AVE
Practice Address - Street 2:STE 404
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1619
Practice Address - Country:US
Practice Address - Phone:214-370-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1167207L00000X, 207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117756003Medicaid
TX8A0499OtherBCBS
TXP00754973OtherRR MEDICARE
TX117756005Medicaid
TX87601KMedicare PIN
TX117756003Medicaid
TX8A0499OtherBCBS
TXB25774Medicare UPIN