Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | J6233 | TX |
NPI | 1033193677 |
---|---|
Provider Name | Dr. Ruby D Saulog |
First Address | Amarillo, TX 79106-1710 |
Second Address | Amarillo, TX 79106-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135291605 | (05) | TX |
F58779 | (02) | TX |