Provider Demographics
NPI:1295596476
Name:DE LA CRUZ, LOUIS PAUL (PHLEBOTOMIST)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:PAUL
Last Name:DE LA CRUZ
Suffix:
Gender:M
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 W SAND HILLS CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-6130
Mailing Address - Country:US
Mailing Address - Phone:480-240-0044
Mailing Address - Fax:
Practice Address - Street 1:1208 W SAND HILLS CT
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-6130
Practice Address - Country:US
Practice Address - Phone:480-240-0044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy