Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | K4201 | TX |
N | 208600000X | Surgeon | K4201 | TX |
Y | 208D00000X | General Practice Physician | K4201 | TX |
NPI | 1003886979 |
---|---|
Provider Name | Dr. Roque Joel Ramirez |
First Address | Robstown, TX 78380-9403 |
Second Address | Robstown, TX 78380-9403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 09/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0800419-01 | (05) | TX |
74-2976976 | TAX ID (01) | TX |
H28818 | (02) | TX |