Provider Demographics
NPI:1295805505
Name:RAMOS, FRANCISCO PORTILLO (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:PORTILLO
Last Name:RAMOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 WEST AVE
Mailing Address - Street 2:STE. 3205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1350
Mailing Address - Country:US
Mailing Address - Phone:210-524-9866
Mailing Address - Fax:210-497-2599
Practice Address - Street 1:11230 WEST AVE
Practice Address - Street 2:STE. 3205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1350
Practice Address - Country:US
Practice Address - Phone:210-524-9866
Practice Address - Fax:210-497-2599
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX793997OtherUNITED CONCORDIA
TX126740302Medicaid
TXB167801OtherTEXAS CHIP DENTAL SERVICE