Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 16960 | MS |
Y | 2080P0214X | Pediatric Pulmonologist | N0418 | TX |
NPI | 1043240500 |
---|---|
Provider Name | Fadel Ernesto Ruiz |
First Address | Houston, TX 77046-0297 |
Second Address | Houston, TX 77030-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 03/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00123150 | (05) | MS |
1436305 | (05) | LA |