Individual
ELISA F CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1002 TEXAS BLVD STE 406, ATTENTION PT DEPT, TEXARKANA, TX 75501-5113
(903) 794-4196
(903) 794-4198
Mailing address
1002 TEXAS BLVD STE 406, ATTENTION PT DEPT, TEXARKANA, TX 75501-5113
(903) 794-4196
(903) 794-4198
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1080893
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83869
BCBS ARKANSAS PROV #
AR
01
—
8T6171
BCBS OF TEXAS
TX
Enumeration date
01/03/2007
Last updated
07/08/2007
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