MEDICARE: WENDY MATA RAMIREZ

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	1041C0700X	Clinical Social Worker	107342	TX

General Provider Information

NPI Number	:	1306792593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY MATA RAMIREZ

Provider Business Mailing Address
First Line	:	425 E LAMAR BLVD APT 403
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-1232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 BICKERS ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75212-1300
Country	:	US
Telephone Number	:	972-581-4334
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ WENDY MATA RAMIREZ ” Practice Location

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