Provider Demographics
NPI:1942629001
Name:CRUZ, JOSE (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:DO
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 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2250
Mailing Address - Fax:956-362-2251
Practice Address - Street 1:2717 MICHAELANGELO DR STE 200
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1412
Practice Address - Country:US
Practice Address - Phone:956-362-2250
Practice Address - Fax:956-362-2251
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310206207P00000X
TXT3757207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine