Individual
RUBY CROX GAITAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3108 S FILLMORE ST, AMARILLO, TX 79110-1026
(806) 374-5516
(806) 373-4769
Mailing address
3108 S FILLMORE ST, AMARILLO, TX 79110-1026
(806) 374-5516
(806) 373-4769
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
57005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57005
LMSW
TX
Enumeration date
09/14/2012
Last updated
09/14/2012
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