Provider Demographics
NPI:1326528183
Name:RAMOS, ANTONIO (LSA)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7050 DONIPHAN DR UNIT 1754
Mailing Address - Street 2:
Mailing Address - City:CANUTILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79835-8068
Mailing Address - Country:US
Mailing Address - Phone:915-449-1209
Mailing Address - Fax:915-532-0012
Practice Address - Street 1:7050 DONIPHAN DR UNIT 1754
Practice Address - Street 2:
Practice Address - City:CANUTILLO
Practice Address - State:TX
Practice Address - Zip Code:79835-8068
Practice Address - Country:US
Practice Address - Phone:915-449-1209
Practice Address - Fax:915-532-0012
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXSA00671TX208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery