Provider Demographics
NPI:1306896014
Name:SOULSBY-MONROY, RUTH ELIZABETH (CNM)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ELIZABETH
Last Name:SOULSBY-MONROY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:
Practice Address - Street 1:1108A E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3907
Practice Address - Country:US
Practice Address - Phone:979-849-9740
Practice Address - Fax:979-849-1094
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654095367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164053402Medicaid
TX164053402Medicaid
TX8B9547Medicare PIN