Provider Demographics
NPI:1619125515
Name:TORRES RAMOS, RANDOLPH (M D)
Entity Type:Individual
Prefix:
First Name:RANDOLPH
Middle Name:
Last Name:TORRES RAMOS
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPURLOCK ST
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-9258
Mailing Address - Country:US
Mailing Address - Phone:787-560-6985
Mailing Address - Fax:
Practice Address - Street 1:510 SPURLOCK ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036
Practice Address - Country:US
Practice Address - Phone:787-560-6985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18077207R00000X
TXQ0582207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18077OtherMEDICAL LICENSE