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Individual
KELLY M RUEDA
Active
Individual
KELLY M RUEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8374NJ
BCBS
TX
01
—
P00794740
MEDICARE RR
TX
Enumeration date
10/15/2009
Last updated
09/11/2019
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