Provider Demographics
NPI:1598049397
Name:TEY, RAMIRO DAVID
Entity Type:Individual
Prefix:MR
First Name:RAMIRO
Middle Name:DAVID
Last Name:TEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 RUSSIAN AVE APT 18
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-2769
Mailing Address - Country:US
Mailing Address - Phone:210-724-4788
Mailing Address - Fax:
Practice Address - Street 1:804 RUSSIAN AVE APT 18
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-2769
Practice Address - Country:US
Practice Address - Phone:210-724-4788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A777777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant