MEDICARE: MARLENE RAMOS D.M.D.

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	122300000X	Dentist	2663	PR
2	122300000X	Dentist	25622	TX

General Provider Information

NPI Number	:	1528035615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENE RAMOS D.M.D.

Provider Business Mailing Address
First Line	:	8340 FM 78 STE 8
Second Line	:
City	:	CONVERSE
State	:	TX
Zip	:	78109-1080
Country	:	US
Telephone Number	:	787-505-4011
Fax Number	:	210-305-5740

Provider Business Practice Location Address
First Line	:	8340 FM 78 # 8
Second Line	:
City	:	CONVERSE
State	:	TX
Zip	:	78109-1080
Country	:	US
Telephone Number	:	210-305-5770
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	06/09/2016

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Directions to “ MARLENE RAMOS D.M.D.” Practice Location

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