Provider Demographics
NPI:1124445697
Name:PABLICO, RAMIL
Entity type:Individual
Prefix:
First Name:RAMIL
Middle Name:
Last Name:PABLICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3826 HILL COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-4190
Mailing Address - Country:US
Mailing Address - Phone:407-780-9239
Mailing Address - Fax:
Practice Address - Street 1:3826 HILL COUNTRY DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-4190
Practice Address - Country:US
Practice Address - Phone:407-780-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-23
Last Update Date:2014-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2092960225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX37265419OtherDRIVERS LICENSE