Healthcare Provider Details

I. General information

NPI: 1801160056
Provider Name (Legal Business Name): GEORGE L RAMOS LMT., HHP.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 LA POBLANA RD NW
ALBUQUERQUE NM
87107-1006
US

IV. Provider business mailing address

1204 LA POBLANA RD NW
ALBUQUERQUE NM
87107
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-1498
  • Fax:
Mailing address:
  • Phone: 505-750-1498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7121
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: