Provider Demographics
NPI:1336489764
Name:RAMIREZ, ANTONIO D (PHD, LPSC)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:D
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PHD, LPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 MANITOU
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1835
Mailing Address - Country:US
Mailing Address - Phone:210-416-8004
Mailing Address - Fax:210-433-2778
Practice Address - Street 1:4603 MANITOU
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1835
Practice Address - Country:US
Practice Address - Phone:210-416-8004
Practice Address - Fax:210-433-2778
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130686103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling