Provider Demographics
NPI:1760587521
Name:RAMIREZ, RAFAEL RICARDO (DDS FAGD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:RICARDO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:DDS FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E GALBRAITH ST
Mailing Address - Street 2:
Mailing Address - City:HEBBRONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78361-3402
Mailing Address - Country:US
Mailing Address - Phone:361-527-4023
Mailing Address - Fax:361-527-4213
Practice Address - Street 1:312 E GALBRAITH ST
Practice Address - Street 2:
Practice Address - City:HEBBRONVILLE
Practice Address - State:TX
Practice Address - Zip Code:78361-3402
Practice Address - Country:US
Practice Address - Phone:361-527-4023
Practice Address - Fax:361-527-4213
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist