Provider Demographics
NPI:1194016287
Name:RAMON QUINONES,MD,PA
Entity Type:Organization
Organization Name:RAMON QUINONES,MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSHBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-564-3243
Mailing Address - Street 1:PO BOX 550335
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75355-0335
Mailing Address - Country:US
Mailing Address - Phone:972-485-5814
Mailing Address - Fax:972-485-5674
Practice Address - Street 1:122 N INTERNATIONAL RD
Practice Address - Street 2:SUITE C
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6530
Practice Address - Country:US
Practice Address - Phone:972-485-5814
Practice Address - Fax:972-485-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2747208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097143402Medicaid
TX097143402Medicaid