Provider Demographics
NPI:1063425452
Name:RUIZ-YEDWAB, BEATRIZ (MD)
Entity type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:
Last Name:RUIZ-YEDWAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BEATRIZ
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4266
Mailing Address - Country:US
Mailing Address - Phone:214-320-1661
Mailing Address - Fax:214-320-1691
Practice Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:SUITE 308
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4266
Practice Address - Country:US
Practice Address - Phone:214-320-1661
Practice Address - Fax:214-320-1691
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5394208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH10850Medicare UPIN