Healthcare Provider Details

I. General information

NPI: 1942763743
Provider Name (Legal Business Name): MARY LUISA RAMOS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 AVENUE E
HONDO TX
78861-3534
US

IV. Provider business mailing address

3100 AVENUE E
HONDO TX
78861-3534
US

V. Phone/Fax

Practice location:
  • Phone: 830-426-7444
  • Fax: 830-426-7467
Mailing address:
  • Phone: 830-426-7444
  • Fax: 830-426-7468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1123048
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: