Provider Demographics
NPI:1639373210
Name:RAMIREZ, MARK ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ADAM
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 62701
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76906-2701
Mailing Address - Country:US
Mailing Address - Phone:325-224-5981
Mailing Address - Fax:325-224-5981
Practice Address - Street 1:3162 APPALOOSA CIR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-5225
Practice Address - Country:US
Practice Address - Phone:325-224-5981
Practice Address - Fax:325-224-5981
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM7551207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W2109OtherBCBS
TX194490201Medicaid
TX8W2109OtherBCBS