Healthcare Provider Details

I. General information

NPI: 1336505965
Provider Name (Legal Business Name): ALICE L. RAMSEY M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 SW 26TH AVE SUITE D
MINERAL WELLS TX
76067-8249
US

IV. Provider business mailing address

214 SW 26TH AVE SUITE D
MINERAL WELLS TX
76067-8249
US

V. Phone/Fax

Practice location:
  • Phone: 940-325-9485
  • Fax: 940-325-4325
Mailing address:
  • Phone: 940-325-9485
  • Fax: 940-325-4325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK2987
License Number StateTX

VIII. Authorized Official

Name: ALICE L RAMSEY
Title or Position: OWNER
Credential: M.D.
Phone: 940-325-9485