Provider Demographics
NPI:1780723114
Name:GUAJARDO, MARIA RUBY (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:RUBY
Last Name:GUAJARDO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1200 E SAVANNAH AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1727
Mailing Address - Country:US
Mailing Address - Phone:956-668-1200
Mailing Address - Fax:956-668-1212
Practice Address - Street 1:1200 E SAVANNAH AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-668-1200
Practice Address - Fax:956-668-1212
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2020-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL4957207V00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152757404Medicaid
TX152757403Medicaid
TX8413B8Medicare PIN