Provider Demographics
NPI:1053076398
Name:RUIZ, PABLO
Entity Type:Individual
Prefix:
First Name:PABLO
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 N 23RD ST STE B2
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6506
Mailing Address - Country:US
Mailing Address - Phone:956-627-4413
Mailing Address - Fax:
Practice Address - Street 1:7108 N 23RD ST STE B2
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6506
Practice Address - Country:US
Practice Address - Phone:956-627-4413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician