Healthcare Provider Details

I. General information

NPI: 1982697850
Provider Name (Legal Business Name): HERIBERTO DANIEL RAMOS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
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 Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number5882TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: