Provider Demographics
NPI:1124056239
Name:CERTIFIED ALLERGY & ASTHMA OF SAN ANTONIO, PA
Entity type:Organization
Organization Name:CERTIFIED ALLERGY & ASTHMA OF SAN ANTONIO, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-3923
Mailing Address - Street 1:8285 FREDERICKSBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-614-3923
Mailing Address - Fax:210-614-9306
Practice Address - Street 1:8285 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3358
Practice Address - Country:US
Practice Address - Phone:210-614-3923
Practice Address - Fax:210-614-9306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89490BOtherBCBS TX
0080AZOtherBCBS OF TX
30003668OtherRAILROAD MEDICARE
TX89491BOtherBCBSTX
TX081181201Medicaid
TX8585MOOtherBCBS TX
TX8585MOOtherBCBS TX