Provider Demographics
NPI:1568502086
Name:RUIZ, LEOPOLDO III (RPH)
Entity Type:Individual
Prefix:
First Name:LEOPOLDO
Middle Name:
Last Name:RUIZ
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 CORPUS CHRISTI STE. #9
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043
Mailing Address - Country:US
Mailing Address - Phone:956-723-2001
Mailing Address - Fax:956-723-2519
Practice Address - Street 1:2100 CORPUS CHRISTI ST STE 9
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-3361
Practice Address - Country:US
Practice Address - Phone:956-723-2001
Practice Address - Fax:956-723-2519
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist