Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | M4499 | TX |
NPI | 1205861218 |
---|---|
Provider Name | Dr. Richard Martin Ruiz |
First Address | Dallas, TX 75246-2003 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182924401 | (05) | TX |
182924402 | (05) | TX |
8H3719 | BCBS (01) | TX |
H92338 | (02) |