MEDICARE: DIANA A RAMIREZ P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1161883	TX

General Provider Information

NPI Number	:	1215989892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA A RAMIREZ P.T.

Provider Business Mailing Address
First Line	:	7430 REMCON CIR
Second Line	:	SUITE B110
City	:	EL PASO
State	:	TX
Zip	:	79912-3514
Country	:	US
Telephone Number	:	915-544-2455
Fax Number	:	915-544-3149

Provider Business Practice Location Address
First Line	:	7430 REMCON CIR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-3514
Country	:	US
Telephone Number	:	915-584-0051
Fax Number	:	915-584-6764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/09/2007

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