Provider Demographics
NPI:1487254025
Name:RAMOS, ANITA ROSALINDA
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:ROSALINDA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 HERITAGE FARMS DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-6706
Mailing Address - Country:US
Mailing Address - Phone:830-352-9083
Mailing Address - Fax:830-757-8001
Practice Address - Street 1:496 S BIBB AVE
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-5063
Practice Address - Country:US
Practice Address - Phone:830-773-9001
Practice Address - Fax:830-757-8001
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist