Provider Demographics
NPI:1104647304
Name:RAMON, ELIZABETH NANCY (MLT(ASCP))
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NANCY
Last Name:RAMON
Suffix:
Gender:F
Credentials:MLT(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17930 VALLEY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5904
Mailing Address - Country:US
Mailing Address - Phone:346-855-6766
Mailing Address - Fax:
Practice Address - Street 1:7600 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1906
Practice Address - Country:US
Practice Address - Phone:713-790-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTC54950246RM2200X
HI6348246RM2200X
TN21725246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory