Provider Demographics
NPI:1548479421
Name:BARRERA, RAMIRO JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMIRO
Middle Name:
Last Name:BARRERA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 E 9TH ST STE 10-A
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4404
Mailing Address - Country:US
Mailing Address - Phone:956-587-5554
Mailing Address - Fax:956-628-4900
Practice Address - Street 1:1123 E 9TH ST STE 10-A
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4404
Practice Address - Country:US
Practice Address - Phone:956-587-5554
Practice Address - Fax:956-628-4900
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13585OtherSTATE LICENSE
TX090327001Medicaid