Healthcare Provider Details

I. General information

NPI: 1285745620
Provider Name (Legal Business Name): RAMON J JUAREZ LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 HORIZON HILL BLVD
SAN ANTONIO TX
78229-2258
US

IV. Provider business mailing address

115 WHITECLIFF DR
SAN ANTONIO TX
78227-4331
US

V. Phone/Fax

Practice location:
  • Phone: 210-321-2707
  • Fax:
Mailing address:
  • Phone: 210-321-2712
  • Fax: 210-321-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29821
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: