Provider Demographics
NPI:1285664862
Name:CRUZ, RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:624 W UNIVERSITY DR
Mailing Address - Street 2:SUITE #397
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-1889
Mailing Address - Country:US
Mailing Address - Phone:940-243-2789
Mailing Address - Fax:940-243-0379
Practice Address - Street 1:2245 BRINKER RD
Practice Address - Street 2:SUITE #100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-6175
Practice Address - Country:US
Practice Address - Phone:940-243-2789
Practice Address - Fax:940-243-0379
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106268904Medicaid
TX8AW639OtherBCBSTX
TXG50032Medicare UPIN
TX8F0018Medicare PIN