Provider Demographics
NPI:1396790747
Name:RAUL RAMOS, M.D., FACS
Entity type:Organization
Organization Name:RAUL RAMOS, M.D., FACS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-1600
Mailing Address - Street 1:PO BOX 848813
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8813
Mailing Address - Country:US
Mailing Address - Phone:210-614-1600
Mailing Address - Fax:210-614-1606
Practice Address - Street 1:540 MADISON OAK DR
Practice Address - Street 2:SUITE 370
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3943
Practice Address - Country:US
Practice Address - Phone:210-614-1600
Practice Address - Fax:210-614-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157186102Medicaid
TX157186102Medicaid