Basic Information
| Provider Information | |||||||||
| NPI: | 1720282304 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ | ||||||||
| FirstName: | KYRALESSA | ||||||||
| MiddleName: | BEATRIZ | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2514 MURICIA DR | ||||||||
| Address2: | |||||||||
| City: | LEAGUE CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775732580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097896910 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4501 GROVEWAY DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770871122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7136441568 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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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 | 208000000X | BP1-0026319 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 3851657178 | 01 | MYUTMB 3851657178-COMMERCIAL NUMBER | OTHER |