Provider Demographics
NPI:1124502943
Name:RUIZ, PHOEBE A
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:A
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15434 W WILLOWWIND CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3232
Mailing Address - Country:US
Mailing Address - Phone:713-885-2667
Mailing Address - Fax:
Practice Address - Street 1:15434 W WILLOWWIND CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3232
Practice Address - Country:US
Practice Address - Phone:713-885-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator