Provider Demographics
NPI:1982659942
Name:RAMOS, SHELLEY BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:BRUCE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:KATHRIN
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 TUSCAN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4133
Mailing Address - Country:US
Mailing Address - Phone:972-401-3200
Mailing Address - Fax:972-401-3230
Practice Address - Street 1:701 TUSCAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-4133
Practice Address - Country:US
Practice Address - Phone:972-401-3200
Practice Address - Fax:972-401-3230
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK1760OtherSTATE LICENSE NUMBER
TX30106078OtherDPS NUMBER
TX30106078OtherDPS NUMBER
TXG83454Medicare UPIN