Provider Demographics
NPI:1104602507
Name:DR RAMON DE LA TORRE MD PLLC
Entity type:Organization
Organization Name:DR RAMON DE LA TORRE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA TORRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-754-0969
Mailing Address - Street 1:220 W HILLSIDE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6903
Mailing Address - Country:US
Mailing Address - Phone:956-724-5656
Mailing Address - Fax:956-724-1344
Practice Address - Street 1:220 W HILLSIDE RD STE 9
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6903
Practice Address - Country:US
Practice Address - Phone:956-724-5656
Practice Address - Fax:956-724-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty