Provider Demographics
NPI:1679689277
Name:RAMIREZ, AMADO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:AMADO
Middle Name:
Last Name:RAMIREZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 GEORGE DIETER DR STE C
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7601
Mailing Address - Country:US
Mailing Address - Phone:915-594-7777
Mailing Address - Fax:915-594-1080
Practice Address - Street 1:1440 GEORGE DIETER DR STE C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7601
Practice Address - Country:US
Practice Address - Phone:915-594-7777
Practice Address - Fax:915-594-1080
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3082208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182400502Medicaid
TX146775503Medicaid
TX8W8920OtherBLUE CROSS BLUE SHIELD
TX182400502Medicaid