Provider Demographics
NPI:1225082894
Name:RAMIREZ, LAURA (PA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 VALHI BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5974
Mailing Address - Country:US
Mailing Address - Phone:985-223-3871
Mailing Address - Fax:985-223-8779
Practice Address - Street 1:578 VALHI BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5974
Practice Address - Country:US
Practice Address - Phone:985-223-3871
Practice Address - Fax:985-223-8779
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10287RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1351636Medicaid
LAS56187Medicare UPIN
LA50643P159Medicare PIN