Provider Demographics
NPI:1467883132
Name:RUIZ, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27689 BAKER POTTS RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3755
Mailing Address - Country:US
Mailing Address - Phone:956-412-2002
Mailing Address - Fax:956-412-2879
Practice Address - Street 1:27689 BAKER POTTS RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3755
Practice Address - Country:US
Practice Address - Phone:956-412-2002
Practice Address - Fax:956-412-2879
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001025974261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care