Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | G8358 | TX |
NPI | 1336212224 |
---|---|
Provider Name | Jesus Ramirez |
First Address | Arlington, TX 76011 |
Second Address | Arlington, TX 76011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |