Provider Demographics
NPI:1851161806
Name:RAMIREZ MARTINEZ, ILIUVA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ILIUVA
Middle Name:
Last Name:RAMIREZ MARTINEZ
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 THORNTON ST APT 325
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76106-2536
Mailing Address - Country:US
Mailing Address - Phone:512-201-5858
Mailing Address - Fax:
Practice Address - Street 1:9751 WALNUT ST STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2345
Practice Address - Country:US
Practice Address - Phone:469-730-3130
Practice Address - Fax:469-730-3154
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1006384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily