Provider Demographics
NPI:1063584761
Name:DILMA C RUIZ MD PA
Entity type:Organization
Organization Name:DILMA C RUIZ MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DILMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUIZ-FRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-545-7270
Mailing Address - Street 1:18518 HARDY OAK BLVD
Mailing Address - Street 2:STE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4759
Mailing Address - Country:US
Mailing Address - Phone:210-545-7270
Mailing Address - Fax:210-497-2432
Practice Address - Street 1:18518 HARDY OAK BLVD
Practice Address - Street 2:STE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4759
Practice Address - Country:US
Practice Address - Phone:210-545-7270
Practice Address - Fax:210-497-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4220208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG52367Medicare UPIN