Provider Demographics
NPI:1578534608
Name:THERESA A RAMEDEN, MD, PA
Entity Type:Organization
Organization Name:THERESA A RAMEDEN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAMEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-534-2766
Mailing Address - Street 1:3828 HUGHES CT
Mailing Address - Street 2:SUITE106
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-6244
Mailing Address - Country:US
Mailing Address - Phone:281-534-2766
Mailing Address - Fax:281-534-0361
Practice Address - Street 1:3828 HUGHES CT
Practice Address - Street 2:SUITE106
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-6244
Practice Address - Country:US
Practice Address - Phone:281-534-2766
Practice Address - Fax:281-534-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00775TMedicare ID - Type Unspecified