Provider Demographics
NPI:1821116385
Name:RUIZ, LUIS ALONSO (MD, LSA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:ALONSO
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD, LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 691789
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-1789
Mailing Address - Country:US
Mailing Address - Phone:832-237-5656
Mailing Address - Fax:832-237-5655
Practice Address - Street 1:8203 WILLOW PLACE DR S
Practice Address - Street 2:SUITE 419
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5655
Practice Address - Country:US
Practice Address - Phone:832-237-5656
Practice Address - Fax:832-237-5655
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00224208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery