Provider Demographics
NPI:1770546756
Name:TORREZ, RUBEN J (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:J
Last Name:TORREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6349 US HIGHWAY 550
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:NM
Mailing Address - Zip Code:87013-6032
Mailing Address - Country:US
Mailing Address - Phone:575-289-3291
Mailing Address - Fax:505-443-8303
Practice Address - Street 1:6349 US HIGHWAY 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013-6032
Practice Address - Country:US
Practice Address - Phone:505-289-3291
Practice Address - Fax:505-443-8303
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU1563207Q00000X
NMMD2004-0096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM12024076Medicaid
343423900Medicare ID - Type Unspecified
NM12024076Medicaid