Healthcare Provider Details

I. General information

NPI: 1629056767
Provider Name (Legal Business Name): HERIBERTO D RAMOS O.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7042 S STAPLES ST STE 101
CORPUS CHRISTI TX
78413-1934
US

IV. Provider business mailing address

7042 S STAPLES ST STE 101
CORPUS CHRISTI TX
78413-1934
US

V. Phone/Fax

Practice location:
  • Phone: 361-980-0523
  • Fax: 361-994-5397
Mailing address:
  • Phone: 361-980-0523
  • Fax: 361-994-5397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5882TG
License Number StateTX

VIII. Authorized Official

Name: HERIBERTO DANIEL RAMOS
Title or Position: PRESIDENT
Credential: O.D.
Phone: 361-980-0523