Provider Demographics
NPI:1396746442
Name:CRUZ, JAIME OSCAR (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:OSCAR
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:155 E SONTERRA BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3988
Mailing Address - Country:US
Mailing Address - Phone:210-314-8045
Mailing Address - Fax:210-314-8073
Practice Address - Street 1:155 E SONTERRA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3988
Practice Address - Country:US
Practice Address - Phone:210-314-8045
Practice Address - Fax:210-314-8073
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH5394207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14929Medicare UPIN