Provider Demographics
NPI:1790473247
Name:EPICAL HEALTHMED FUNCTIONAL PRACTICE PLLC
Entity Type:Organization
Organization Name:EPICAL HEALTHMED FUNCTIONAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ARMANDO
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-929-8150
Mailing Address - Street 1:2112 S SHARY RD STE 7
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-0009
Mailing Address - Country:US
Mailing Address - Phone:956-289-3142
Mailing Address - Fax:877-600-3491
Practice Address - Street 1:2112 S SHARY RD STE 7
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-0009
Practice Address - Country:US
Practice Address - Phone:956-600-7258
Practice Address - Fax:877-600-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty