Provider Demographics
NPI:1902198880
Name:EBANGIT, RUTH LAVONE (MD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LAVONE
Last Name:EBANGIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1117
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521
Mailing Address - Country:US
Mailing Address - Phone:940-864-2779
Mailing Address - Fax:
Practice Address - Street 1:1 NORTH AVE N
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:TX
Practice Address - Zip Code:79521
Practice Address - Country:US
Practice Address - Phone:940-864-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0430207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine