Provider Demographics
NPI:1699844985
Name:CRUZ GROST, DIGNA CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:DIGNA
Middle Name:CRISTINA
Last Name:CRUZ GROST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIGNA
Other - Middle Name:CRISTINA
Other - Last Name:CRUZ ESCALONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:619 E CROSBY AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4316
Mailing Address - Country:US
Mailing Address - Phone:915-497-2618
Mailing Address - Fax:
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:ROOM 1-170
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-569-1386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK00122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry