Provider Demographics
NPI:1962553255
Name:RUIZ, HEINE (MD)
Entity type:Individual
Prefix:
First Name:HEINE
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 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-4997
Mailing Address - Fax:
Practice Address - Street 1:106 VISION PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3000
Practice Address - Country:US
Practice Address - Phone:713-442-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3078207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1980864-01Medicaid
TX198086402Medicaid
TX8CU219OtherBCBS
P00614422OtherRAILROAD
TX198086406Medicaid
TX8BG163OtherBCBS
TX8BG163OtherBCBS
P00614422OtherRAILROAD
TX463638ZNKTMedicare PIN
TXTXB124711Medicare PIN
TX463638ZNKQMedicare PIN