Provider Demographics
NPI:1063735298
Name:RAMIREZ, DIANA E (ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:E
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 OTTAWA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-2673
Mailing Address - Country:US
Mailing Address - Phone:512-402-0219
Mailing Address - Fax:
Practice Address - Street 1:1007 OTTAWA DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-2673
Practice Address - Country:US
Practice Address - Phone:512-608-1922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT44042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer