Basic Information
| Provider Information | |||||||||
| NPI: | 1376025569 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ-NIEDENBERGER | ||||||||
| FirstName: | CARRIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1053 | ||||||||
| Address2: | |||||||||
| City: | POTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781471053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305343434 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1615 11TH ST | ||||||||
| Address2: | |||||||||
| City: | FLORESVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781142403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302167090 | ||||||||
| FaxNumber: | 8303930381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2018 | ||||||||
| LastUpdateDate: | 09/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 109146 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 109146 | 01 | TX | OCCUPATIONAL THERAPY | OTHER |