Provider Demographics
NPI:1902080856
Name:RUIZ, ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-0008
Mailing Address - Country:US
Mailing Address - Phone:956-647-8600
Mailing Address - Fax:956-969-9564
Practice Address - Street 1:1001 JAMES ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-0008
Practice Address - Country:US
Practice Address - Phone:956-647-8600
Practice Address - Fax:956-969-9564
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5375207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212293903Medicaid
TXTXB152391Medicare PIN
TX212293903Medicaid