Healthcare Provider Details

I. General information

NPI: 1306762034
Provider Name (Legal Business Name): MAKAYLAH RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W COLLEGE ST
GRAPEVINE TX
76051-3580
US

IV. Provider business mailing address

12105 DURANGO ROOT DR
FORT WORTH TX
76244-6404
US

V. Phone/Fax

Practice location:
  • Phone: 682-439-0091
  • Fax:
Mailing address:
  • Phone: 817-863-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: