Provider Demographics
NPI:1336218494
Name:RAMIREZ, JORGE RODRIGUEZ (SAOO221)
Entity type:Individual
Prefix:MR
First Name:JORGE
Middle Name:RODRIGUEZ
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:SAOO221
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1319 COPPERMEADE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3503
Mailing Address - Country:US
Mailing Address - Phone:713-530-0649
Mailing Address - Fax:281-873-8563
Practice Address - Street 1:1319 COPPERMEADE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3503
Practice Address - Country:US
Practice Address - Phone:713-530-0649
Practice Address - Fax:281-873-8563
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00221363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical