Provider Demographics
NPI:1518404037
Name:HENRI BIENVENIDO RAMIREZ MENDEZ/ BEEWELL FAMILY HEALTHCARE
Entity Type:Organization
Organization Name:HENRI BIENVENIDO RAMIREZ MENDEZ/ BEEWELL FAMILY HEALTHCARE
Other - Org Name:HENRI BIENVENIDO RAMIREZ MENDEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-208-1512
Mailing Address - Street 1:PO BOX 1154
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953
Mailing Address - Country:US
Mailing Address - Phone:918-208-7497
Mailing Address - Fax:918-208-7687
Practice Address - Street 1:500 S BROADWAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-3818
Practice Address - Country:US
Practice Address - Phone:918-207-7497
Practice Address - Fax:918-208-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8626208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty