Provider Demographics
NPI:1760751671
Name:RAMIRO E VERDOOREN M D P A
Entity Type:Organization
Organization Name:RAMIRO E VERDOOREN M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:VERDOOREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-7796
Mailing Address - Street 1:801 E NOLANA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6113
Mailing Address - Country:US
Mailing Address - Phone:956-687-7796
Mailing Address - Fax:956-687-2308
Practice Address - Street 1:801 E NOLANA AVE STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6113
Practice Address - Country:US
Practice Address - Phone:956-687-7796
Practice Address - Fax:956-687-2308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2493207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033010201Medicaid
TX033010201Medicaid