Provider Demographics
NPI:1790155083
Name:RAMOS, ANIBAL (LMT)
Entity Type:Individual
Prefix:
First Name:ANIBAL
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 KELLER SPRINGS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4829
Mailing Address - Country:US
Mailing Address - Phone:469-556-4799
Mailing Address - Fax:
Practice Address - Street 1:2840 KELLER SPRINGS RD
Practice Address - Street 2:SUITE 301
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-4829
Practice Address - Country:US
Practice Address - Phone:469-556-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT025986172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist