Provider Demographics
NPI:1104302090
Name:RAMOS, MAYRA (AGACNP)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 FOLEY RD
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-7249
Mailing Address - Country:US
Mailing Address - Phone:832-629-9123
Mailing Address - Fax:
Practice Address - Street 1:1602 W BAKER RD STE 201
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2282
Practice Address - Country:US
Practice Address - Phone:281-428-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321205164X00000X
TX1177943363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No164X00000XNursing Service ProvidersLicensed Vocational Nurse