Provider Demographics
NPI:1932404043
Name:SHELLEY BRUCE RAMOS, MD PA
Entity Type:Organization
Organization Name:SHELLEY BRUCE RAMOS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD PA
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-3200
Mailing Address - Street 1:701 TUSCAN DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4133
Mailing Address - Country:US
Mailing Address - Phone:972-401-3200
Mailing Address - Fax:972-401-3230
Practice Address - Street 1:701 TUSCAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-4133
Practice Address - Country:US
Practice Address - Phone:972-401-3200
Practice Address - Fax:972-401-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty