Provider Demographics
NPI:1336744747
Name:RAMOS, GABRIEL (CRNA)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 S PALM COURT DR APT 12205
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-4434
Mailing Address - Country:US
Mailing Address - Phone:915-999-8721
Mailing Address - Fax:
Practice Address - Street 1:2805 VICTORIA PARK DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4016
Practice Address - Country:US
Practice Address - Phone:915-999-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX887514363L00000X
TX1029191367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner