Provider Demographics
NPI:1124585708
Name:CABRERA, RAMIRO (OTR)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:CABRERA
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S FESTIVAL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5801
Mailing Address - Country:US
Mailing Address - Phone:915-842-1788
Mailing Address - Fax:915-842-1778
Practice Address - Street 1:109 S FESTIVAL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5801
Practice Address - Country:US
Practice Address - Phone:915-842-1788
Practice Address - Fax:915-842-1778
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119796OtherLICENSE