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General NPI Number Information
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NPI Number | 1679908602
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Entity Type | Organization
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Legal Business Name | ADVANCED CLINICIAN, MULTISPECIALTY CLINICAL CONSULTANT SERVICES, PLLC
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 5101 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4801
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Country | US
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Telephone | 210-802-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 17503 LA CANTERA PKWY # 104-404
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City | SAN ANTONIO
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State | TX
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Zip | 78257-8207
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Country | US
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Telephone | 210-802-1661
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Fax | 210-579-6710
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSE A. RAMOS
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Credential | APRN, ACNP
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Telephone | 832-264-0756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 697419
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License Number State | TX
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