Provider Demographics
NPI:1093020497
Name:TRUJILLO, RUT ALICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:RUT
Middle Name:ALICIA
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:RUTH
Other - Middle Name:ALICIA
Other - Last Name:ESCANDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5000 N 23RD ST
Mailing Address - Street 2:SUITE K
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4013
Mailing Address - Country:US
Mailing Address - Phone:956-278-3777
Mailing Address - Fax:800-396-9360
Practice Address - Street 1:5000 N 23RD ST
Practice Address - Street 2:SUITE K
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4013
Practice Address - Country:US
Practice Address - Phone:956-278-3777
Practice Address - Fax:800-396-9360
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX651073171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator