Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | K7644 | TX |
NPI | 1003815499 |
---|---|
Provider Name | Ruben J Almanza |
First Address | Corpus Christi, TX 78413-2509 |
Second Address | Corpus Christi, TX 78413-2509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 14/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178929901 | (05) | TX |
Y38744 | (02) | TX |