Provider Demographics
NPI:1063438919
Name:CRUZ, ROXANA L (MD)
Entity type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:L
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4501 JOE RAMSEY BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402
Mailing Address - Country:US
Mailing Address - Phone:903-408-5800
Mailing Address - Fax:903-455-8232
Practice Address - Street 1:4501 JOE RAMSEY BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402
Practice Address - Country:US
Practice Address - Phone:903-408-5800
Practice Address - Fax:903-455-8232
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY215800207R00000X
TXK9759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040659717Medicaid
TX040659717Medicaid
NYH12751Medicare UPIN