Provider Demographics
NPI:1962561852
Name:RAMOS, ROBERTO (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 SAN BERNARDO AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5710
Mailing Address - Country:US
Mailing Address - Phone:956-729-0061
Mailing Address - Fax:956-729-1019
Practice Address - Street 1:4810 SAN BERNARDO AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5710
Practice Address - Country:US
Practice Address - Phone:956-729-0061
Practice Address - Fax:956-729-1019
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06763TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV06516Medicare UPIN