Provider Demographics
NPI:1992589790
Name:RAMOS, PHIL MATTHEW (PMHNP)
Entity type:Individual
Prefix:
First Name:PHIL
Middle Name:MATTHEW
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 N WESTMORELAND RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2269
Mailing Address - Country:US
Mailing Address - Phone:972-224-8606
Mailing Address - Fax:
Practice Address - Street 1:10440 N CENTRAL EXPY STE 1040.4
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2221
Practice Address - Country:US
Practice Address - Phone:972-449-8300
Practice Address - Fax:713-583-1504
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1131198363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health