Provider Demographics
NPI:1285316992
Name:RUIZ, MICAH (HIS)
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:RUIZ
Suffix:
Gender:
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16607 BLANCO RD STE 602
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1941
Mailing Address - Country:US
Mailing Address - Phone:210-858-8331
Mailing Address - Fax:
Practice Address - Street 1:16607 BLANCO RD STE 602
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1941
Practice Address - Country:US
Practice Address - Phone:210-858-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter