Provider Demographics
NPI:1437866548
Name:WILLIS, RAMONA MICHELLE (LOTA)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:MICHELLE
Last Name:WILLIS
Suffix:
Gender:M
Credentials:LOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 NORMANDY ST APT 727
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-3475
Mailing Address - Country:US
Mailing Address - Phone:816-721-1877
Mailing Address - Fax:
Practice Address - Street 1:794 NORMANDY ST APT 727
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-3475
Practice Address - Country:US
Practice Address - Phone:816-721-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician