Healthcare Provider Details

I. General information

NPI: 1164975470
Provider Name (Legal Business Name): LAURA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 GATEWAY BLVD W BLDG 13 10501 GATEWAY WEST BLVD BUILDING 13
EL PASO TX
79925-7929
US

IV. Provider business mailing address

10501 GATEWAY BLVD W BLDG 13 10501 GATEWAY WEST BLVD BUILDING 13
EL PASO TX
79925-7929
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-3500
  • Fax:
Mailing address:
  • Phone: 915-544-3500
  • Fax: 915-532-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: