Individual
NICOLE ELIZABETH CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5228 W PLANO PKWY, PLANO, TX 75093-5005
(972) 250-5700
(972) 250-5748
Mailing address
2500 N HOUSTON ST, APT 603, DALLAS, TX 75219-7655
(972) 250-5700
(972) 250-5748
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TEMPORARY LICENSE
TEXAS STATE LICENSE TEMPORARY
TX
Enumeration date
05/18/2010
Last updated
07/08/2013
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