Provider Demographics
NPI:1952480907
Name:RAMOS, VINCENT (PHD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-6119
Mailing Address - Country:US
Mailing Address - Phone:972-838-8571
Mailing Address - Fax:
Practice Address - Street 1:701 N PRESTON RD STE 100
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3748
Practice Address - Country:US
Practice Address - Phone:972-838-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24184103T00000X
TX30223103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612771Medicare PIN