MEDICARE: ELIDA ANN RAMOS

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	111N00000X	Chiropractor	29086023	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	29086023	OTHER	TX	STATE IDENTIFICATION

General Provider Information

NPI Number	:	1407466717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIDA ANN RAMOS

Provider Business Mailing Address
First Line	:	3011 S FLORES ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78204-2634
Country	:	US
Telephone Number	:	210-794-5040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3011 S FLORES ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78204-2634
Country	:	US
Telephone Number	:	210-794-5040
Fax Number	:

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

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	08/03/2020

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Directions to “ ELIDA ANN RAMOS ” Practice Location

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