Healthcare Provider Details

I. General information

NPI: 1780811489
Provider Name (Legal Business Name): LUCIA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 JAIME ZAPATA MEMORIAL HWY SUITE 1
LAREDO TX
78043-4769
US

IV. Provider business mailing address

102 PALO ALTO RD STE 120
SAN ANTONIO TX
78211-3773
US

V. Phone/Fax

Practice location:
  • Phone: 956-753-6355
  • Fax: 956-753-6331
Mailing address:
  • Phone: 210-922-1785
  • Fax: 210-922-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number108418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: