Healthcare Provider Details

I. General information

NPI: 1801317599
Provider Name (Legal Business Name): KIRSTI RAMIREZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 TOEPPERWEIN STE 121
SAN ANTONIO TX
78233-2384
US

IV. Provider business mailing address

12702 TOEPPERWEIN STE 121
SAN ANTONIO TX
78233-2384
US

V. Phone/Fax

Practice location:
  • Phone: 210-283-6832
  • Fax:
Mailing address:
  • Phone: 210-637-5742
  • Fax: 210-590-3458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9218T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: