| Organization Name: | IVAN RAMIREZ |
| NPI Number: | 1053464008 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUAN IVAN RAMIREZ (PRESIDENT) |
| Mailing Address: | 9670 Ranch Road 12 Wimberley |
| State: | TX US |
| Postal Code: | 786765238 |
| Phone Number: | 5128476789 |
| Fax Number: | 5128477968 |
| NPI Enumeration Date: | 01/20/2007 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | J9290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |