Provider Demographics
NPI:1841236361
Name:RAMON A. CRUZ, MD, PA
Entity Type:Organization
Organization Name:RAMON A. CRUZ, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-243-2789
Mailing Address - Street 1:624 W. UNIVERSITY DR
Mailing Address - Street 2:BOX 397
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201
Mailing Address - Country:US
Mailing Address - Phone:940-243-2789
Mailing Address - Fax:940-220-5229
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
Practice Address - Country:US
Practice Address - Phone:940-243-2789
Practice Address - Fax:940-220-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095RFOtherBCBSTX
TX175489701Medicaid
TX175489701Medicaid
TX00821YMedicare PIN