Provider Demographics
NPI:1528228772
Name:R. SERGIO RAMIREZ, M.D., P.A.
Entity Type:Organization
Organization Name:R. SERGIO RAMIREZ, M.D., P.A.
Other - Org Name:ALTON PEDIATRIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:SERGIO
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-585-6611
Mailing Address - Street 1:210 S BRYAN RD
Mailing Address - Street 2:SUITE 5 A
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6204
Mailing Address - Country:US
Mailing Address - Phone:956-583-2993
Mailing Address - Fax:956-583-4525
Practice Address - Street 1:816 E MAIN AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-6962
Practice Address - Country:US
Practice Address - Phone:956-583-2993
Practice Address - Fax:956-583-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079605401Medicaid
TX079605401Medicaid