Provider Demographics
NPI:1568471712
Name:RAMOS, GENA LYNN (PT,MPT)
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:LYNN
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PT,MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LAFAYETTE PL
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-4791
Mailing Address - Country:US
Mailing Address - Phone:432-557-4835
Mailing Address - Fax:
Practice Address - Street 1:3 LAFAYETTE PL
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-4791
Practice Address - Country:US
Practice Address - Phone:432-557-4835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1123792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist