Provider Demographics
NPI:1326818774
Name:SOUTH TEXAS HEALTH ALLIANCE, PLLC.
Entity Type:Organization
Organization Name:SOUTH TEXAS HEALTH ALLIANCE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:NIKLOLE
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:361-389-3234
Mailing Address - Street 1:2582 MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-6054
Mailing Address - Country:US
Mailing Address - Phone:361-389-3234
Mailing Address - Fax:
Practice Address - Street 1:2582 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-6054
Practice Address - Country:US
Practice Address - Phone:361-389-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty