Provider Demographics
NPI:1700955903
Name:RUIZ, DILMA C (MD)
Entity Type:Individual
Prefix:DR
First Name:DILMA
Middle Name:C
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DILMA
Other - Middle Name:RUIZ
Other - Last Name:FRIEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18518 HARDY OAK BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4759
Mailing Address - Country:US
Mailing Address - Phone:210-545-7270
Mailing Address - Fax:210-497-2432
Practice Address - Street 1:18518 HARDY OAK BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4759
Practice Address - Country:US
Practice Address - Phone:210-545-7270
Practice Address - Fax:210-497-2432
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4220208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15524647Medicaid
TX15524647Medicaid