Provider Demographics
NPI:1285929505
Name:RAMOS, GLENDA L (MS, OTR)
Entity type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:L
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MAYFAIR ST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4612
Mailing Address - Country:US
Mailing Address - Phone:956-353-9508
Mailing Address - Fax:866-610-1692
Practice Address - Street 1:901 E REDBUD AVE STE 5A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4673
Practice Address - Country:US
Practice Address - Phone:956-353-9508
Practice Address - Fax:866-610-1692
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113726225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist