Provider Demographics
NPI:1275900458
Name:TEJADA, RUTH (RN, WHNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:TEJADA
Suffix:
Gender:F
Credentials:RN, WHNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:GONDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, WHNP
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:832-548-5000
Mailing Address - Fax:
Practice Address - Street 1:1415 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2602
Practice Address - Country:US
Practice Address - Phone:832-548-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128894363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health