Provider Demographics
NPI:1245410786
Name:RAMON C. TY, JR, MD, PA,
Entity Type:Organization
Organization Name:RAMON C. TY, JR, MD, PA,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:C
Authorized Official - Last Name:TY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:713-779-3789
Mailing Address - Street 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 565
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1807
Mailing Address - Country:US
Mailing Address - Phone:713-779-3789
Mailing Address - Fax:713-779-6789
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE 565
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-779-3789
Practice Address - Fax:713-779-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191427701Medicaid
TX00975YMedicare PIN