Provider Demographics
NPI:1073799920
Name:RAMIREZ, ILERETTE H (RD/LD)
Entity Type:Individual
Prefix:MRS
First Name:ILERETTE
Middle Name:H
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:MRS
Other - First Name:ILERETTE
Other - Middle Name:
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD/LD
Mailing Address - Street 1:801 E FERN AVE
Mailing Address - Street 2:SUITE 168
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1496
Mailing Address - Country:US
Mailing Address - Phone:956-458-0874
Mailing Address - Fax:
Practice Address - Street 1:801 E FERN AVE
Practice Address - Street 2:SUITE 168
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1496
Practice Address - Country:US
Practice Address - Phone:956-458-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80162133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered