Provider Demographics
NPI:1336758580
Name:ESTEMCDONALD, JORGE RAMIEZ (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:RAMIEZ
Last Name:ESTEMCDONALD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 E BROOKE FLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-0299
Mailing Address - Country:US
Mailing Address - Phone:337-853-2788
Mailing Address - Fax:
Practice Address - Street 1:3965 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6848
Practice Address - Country:US
Practice Address - Phone:409-899-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist