Provider Demographics
NPI:1982198370
Name:BARRUETARAMOS, ROSAURA
Entity Type:Individual
Prefix:
First Name:ROSAURA
Middle Name:
Last Name:BARRUETARAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 LEGEND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:DALE
Mailing Address - State:TX
Mailing Address - Zip Code:78616-2301
Mailing Address - Country:US
Mailing Address - Phone:512-826-7958
Mailing Address - Fax:
Practice Address - Street 1:13915 BURNETT RD, STE 303
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728
Practice Address - Country:US
Practice Address - Phone:512-996-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NON3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNONEOtherNONE
NONOtherNON