Healthcare Provider Details

I. General information

NPI: 1083792105
Provider Name (Legal Business Name): CHARINA MARIE RAMIREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BOULEVARD
DALLAS TX
75390-7208
US

IV. Provider business mailing address

P.O. BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-0117
  • Fax: 214-456-8005
Mailing address:
  • Phone: 214-456-0117
  • Fax: 214-456-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM2761
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberM2761
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: