Provider Demographics
NPI:1144410119
Name:RAMIREZ, MIGUEL A (CSA)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 GATEWAY BLVD W
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7934
Mailing Address - Country:US
Mailing Address - Phone:915-875-1200
Mailing Address - Fax:
Practice Address - Street 1:10501 GATEWAY BLVD W
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7934
Practice Address - Country:US
Practice Address - Phone:915-875-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2976363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical