Provider Demographics
NPI:1508518838
Name:RUELAS, VANESSA GRISELDA
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:GRISELDA
Last Name:RUELAS
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 1:2468 HAMBURG ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-3816
Mailing Address - Country:US
Mailing Address - Phone:956-543-5975
Mailing Address - Fax:
Practice Address - Street 1:2468 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-3816
Practice Address - Country:US
Practice Address - Phone:956-543-5975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant