MEDICARE: RAUL RAMIREZ III LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT049002	TX

General Provider Information

NPI Number	:	1154972545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL RAMIREZ III LMT

Provider Business Mailing Address
First Line	:	18818 MEISNER DR STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3569
Country	:	US
Telephone Number	:	210-481-6800
Fax Number	:	210-481-1444

Provider Business Practice Location Address
First Line	:	18818 MEISNER DR STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3569
Country	:	US
Telephone Number	:	210-481-6800
Fax Number	:	210-481-1444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2019
Last Update Date	:	09/26/2019

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