Individual
MARIO A RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3315 COLORADO BLVD, SUITE 102, DENTON, TX 76210-6884
(940) 320-1708
(940) 565-5457
Mailing address
3315 COLORADO BLVD, SUITE 102, DENTON, TX 76210-6884
(940) 320-1708
(940) 565-5457
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
K2993
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132484008
—
TX
01
—
390008040
RR MEDICARE
—
Enumeration date
11/04/2005
Last updated
12/17/2015
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