Provider Demographics
NPI:1457653669
Name:EDID RAMOS, MD, PA
Entity Type:Organization
Organization Name:EDID RAMOS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDID
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAMOS RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-228-4888
Mailing Address - Street 1:315 E PLEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3933
Mailing Address - Country:US
Mailing Address - Phone:972-228-4888
Mailing Address - Fax:972-228-3336
Practice Address - Street 1:315 E PLEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3933
Practice Address - Country:US
Practice Address - Phone:972-228-4888
Practice Address - Fax:972-228-3336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9291261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care