Provider Demographics
NPI:1265512370
Name:R. SERGIO RAMIREZ M.D., P.A.
Entity type:Organization
Organization Name:R. SERGIO RAMIREZ M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:SERGIO
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-585-6611
Mailing Address - Street 1:210 S BRYAN RD
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6204
Mailing Address - Country:US
Mailing Address - Phone:956-585-6611
Mailing Address - Fax:956-585-1822
Practice Address - Street 1:210 S BRYAN RD
Practice Address - Street 2:SUITE 5A
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6204
Practice Address - Country:US
Practice Address - Phone:956-585-6611
Practice Address - Fax:956-585-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307576402Medicaid
TX8S1881OtherBLUE CROSS BLUE SHILDS
TX1373177-08Medicaid
TX081851001Medicaid
TX120273OtherSUPIRIOR HEALTH PLAN
TX1373177-09Medicaid
TX079605401Medicaid
TX307576401Medicaid
TX307576403Medicaid
TX1373177-08Medicaid