Healthcare Provider Details

I. General information

NPI: 1144381633
Provider Name (Legal Business Name): IRIS Y RAMOS SANTIAGO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 W TRENTON RD
EDINBURG TX
78539-5070
US

IV. Provider business mailing address

1378 SQUAW VALLEY DR UNIT A
BROWNSVILLE TX
78520-9807
US

V. Phone/Fax

Practice location:
  • Phone: 956-994-3880
  • Fax: 956-994-3877
Mailing address:
  • Phone: 956-545-8077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: