Provider Demographics
NPI:1629861711
Name:RAMIREZ-HERMOSILLO, CASSY MARIE
Entity type:Individual
Prefix:
First Name:CASSY
Middle Name:MARIE
Last Name:RAMIREZ-HERMOSILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3860 IH 10 EAST HOUSTON ST.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:210-644-5020
Mailing Address - Fax:210-702-6922
Practice Address - Street 1:3860 IH 10 EAST HOUSTON ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-4063
Practice Address - Country:US
Practice Address - Phone:210-644-5020
Practice Address - Fax:210-702-6922
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195078363LF0000X
TX933911163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care