Provider Demographics
NPI:1598915399
Name:RAMIREZ, DIANA IRASELI (OD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:IRASELI
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-4923
Mailing Address - Country:US
Mailing Address - Phone:210-433-2020
Mailing Address - Fax:210-433-6006
Practice Address - Street 1:918 BANDERA RD.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-2097
Practice Address - Country:US
Practice Address - Phone:210-433-2020
Practice Address - Fax:210-433-6006
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7301T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist