Provider Demographics
NPI:1285893743
Name:RUBEN BARRON D.D.S, P.C.
Entity type:Organization
Organization Name:RUBEN BARRON D.D.S, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PC
Authorized Official - Phone:830-773-8528
Mailing Address - Street 1:1975 N VETERANS BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4456
Mailing Address - Country:US
Mailing Address - Phone:830-773-8528
Mailing Address - Fax:830-773-8711
Practice Address - Street 1:1975 N VETERANS BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4456
Practice Address - Country:US
Practice Address - Phone:830-773-8528
Practice Address - Fax:830-773-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009841001Medicaid
TX1902028855Medicaid