Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | AP144057 | TX |
NPI | 1003448416 |
---|---|
Provider Name | Ruben A Armendariz |
First Address | Mission, TX 78572-4529 |
Second Address | Alamo, TX 78516-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2020 |
Last Update Date | 04/02/2020 |