Healthcare Provider Details

I. General information

NPI: 1326035122
Provider Name (Legal Business Name): ERNESTO JOSE GARCIA-RAMOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 VERSAILLES BLVD
ALEXANDRIA LA
71303-2493
US

IV. Provider business mailing address

PO BOX 13030
ALEXANDRIA LA
71315-3030
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-9331
  • Fax: 318-619-6899
Mailing address:
  • Phone: 318-445-9331
  • Fax: 318-619-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number200159
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number200159
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: