Provider Demographics
NPI:1124197934
Name:VERDOOREN, RAMIRO ENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMIRO
Middle Name:ENRIQUE
Last Name:VERDOOREN
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 1:801 E NOLANA
Mailing Address - Street 2:STE 1
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504
Mailing Address - Country:US
Mailing Address - Phone:956-687-7796
Mailing Address - Fax:956-687-2308
Practice Address - Street 1:801 E NOLANA
Practice Address - Street 2:STE 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504
Practice Address - Country:US
Practice Address - Phone:956-687-7796
Practice Address - Fax:956-687-2308
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2493207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033010201Medicaid
TX00EN89Medicare ID - Type Unspecified
TX033010201Medicaid
OOEN89Medicare UPIN