Healthcare Provider Details

I. General information

NPI: 1295699080
Provider Name (Legal Business Name): DONALD RAMOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 SW F AVE
LAWTON OK
73501-4506
US

IV. Provider business mailing address

807 SW F AVE
LAWTON OK
73501-4506
US

V. Phone/Fax

Practice location:
  • Phone: 580-919-9662
  • Fax:
Mailing address:
  • Phone: 580-919-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: