Provider Demographics
NPI:1780992339
Name:BALDERAS, RUBY MAE (PA-C)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:MAE
Last Name:BALDERAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12412 JUDSON RD
Mailing Address - Street 2:EMERGENCY ROOM
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3255
Mailing Address - Country:US
Mailing Address - Phone:210-757-7000
Mailing Address - Fax:
Practice Address - Street 1:301 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-3098
Practice Address - Country:US
Practice Address - Phone:956-632-4000
Practice Address - Fax:956-632-4010
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2019-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06842363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant