Provider Demographics
NPI:1801673025
Name:RAMIREZ, MICHAEL RAFAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAFAEL
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LORENZ RD APT 204
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2508
Mailing Address - Country:US
Mailing Address - Phone:830-534-5672
Mailing Address - Fax:
Practice Address - Street 1:100 LORENZ RD APT 204
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2508
Practice Address - Country:US
Practice Address - Phone:830-534-5672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123909225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist