Provider Demographics
NPI:1750020715
Name:RAMOS, MELISSA GRACE (PTA, REHAB DIRECTOR)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:GRACE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PTA, REHAB DIRECTOR
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:GRACE
Other - Last Name:SILVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4650 COLE AVE APT 136
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4086
Mailing Address - Country:US
Mailing Address - Phone:424-675-0337
Mailing Address - Fax:
Practice Address - Street 1:12271 COIT RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2300
Practice Address - Country:US
Practice Address - Phone:469-730-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2069283225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant