Provider Demographics
NPI:1972681401
Name:RAMIREZ, ANTONIO (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 N 23RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4131
Mailing Address - Country:US
Mailing Address - Phone:956-687-6567
Mailing Address - Fax:956-682-3344
Practice Address - Street 1:4013 N 23RD ST STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4131
Practice Address - Country:US
Practice Address - Phone:956-687-6567
Practice Address - Fax:956-682-3344
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5154TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019355901Medicaid
TXU57969Medicare UPIN
TX019355901Medicaid