Provider Demographics
NPI:1275664880
Name:RENE R RAMIREZ SR
Entity Type:Organization
Organization Name:RENE R RAMIREZ SR
Other - Org Name:SCIENTIFIC MEDICAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:MT
Authorized Official - Phone:956-664-0600
Mailing Address - Street 1:2704 E GRIFFIN PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3306
Mailing Address - Country:US
Mailing Address - Phone:956-664-0600
Mailing Address - Fax:956-664-9552
Practice Address - Street 1:2704 E GRIFFIN PKWY
Practice Address - Street 2:STE A
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3306
Practice Address - Country:US
Practice Address - Phone:956-664-0600
Practice Address - Fax:956-664-9552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095225101Medicaid
TX095225101Medicaid