Provider Demographics
NPI:1902028855
Name:BARRON, RUBEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:BARRON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 LAS CIMAS DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-6424
Mailing Address - Country:US
Mailing Address - Phone:830-968-3854
Mailing Address - Fax:830-773-8711
Practice Address - Street 1:1975 VERTERANS BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852
Practice Address - Country:US
Practice Address - Phone:830-773-8448
Practice Address - Fax:830-773-8711
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009841001Medicaid
TX007702601Medicaid