Healthcare Provider Details

I. General information

NPI: 1083818884
Provider Name (Legal Business Name): ALMA CRISEIDA BERLINGERI RAMOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1367 DOMINION PLZ
TYLER TX
75703
US

IV. Provider business mailing address

1367 DOMINION PLZ
TYLER TX
75703-1013
US

V. Phone/Fax

Practice location:
  • Phone: 903-534-6200
  • Fax: 903-939-0755
Mailing address:
  • Phone: 903-534-6200
  • Fax: 903-939-0755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number26080R
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberN3493
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberN3493
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: