Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 104877 | TX |
NPI | 1144764010 |
---|---|
Provider Name | Guadalupe Ramirez |
First Address | Lubbock, TX 79407-2729 |
Second Address | Lubbock, TX 79407-2729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2016 |
Last Update Date | 13/12/2016 |