Provider Demographics
NPI:1407171044
Name:RAMOS PROSTHETICS & PEDORTHICS
Entity Type:Organization
Organization Name:RAMOS PROSTHETICS & PEDORTHICS
Other - Org Name:PREMIER PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:MORALES
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:LP, CP, CPED
Authorized Official - Phone:210-340-2181
Mailing Address - Street 1:8519 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4948
Mailing Address - Country:US
Mailing Address - Phone:210-340-2181
Mailing Address - Fax:210-340-2182
Practice Address - Street 1:8519 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4948
Practice Address - Country:US
Practice Address - Phone:210-340-2181
Practice Address - Fax:210-340-2182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101203335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010855701Medicaid
TX1247730001Medicare NSC