Provider Demographics
NPI:1740380757
Name:RAMIREZ, SYLVIA ANGIE (OD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ANGIE
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 1:280 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3600
Mailing Address - Country:US
Mailing Address - Phone:956-488-0808
Mailing Address - Fax:956-488-0258
Practice Address - Street 1:280 W 2ND ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3600
Practice Address - Country:US
Practice Address - Phone:956-488-0808
Practice Address - Fax:956-488-0258
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05448T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80360QOtherBLUE CROSS BLUE SHIELD
TX0929960-01Medicaid
TX0929960-01Medicaid
TX8F21474Medicare PIN
TX67524Medicare UPIN