Organization
RUBEN R RONCALLO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGARDO ANTONIO CERA (MANAGER)
(915) 532-9000
Entity
Organization
Contact information
Practice address
4500 N MESA ST, EL PASO, TX 79912-6102
(915) 532-9000
Mailing address
4500 N MESA ST, EL PASO, TX 79912-6102
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
K9162
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101868104
—
TX
Enumeration date
04/30/2014
Last updated
04/30/2014
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