Individual
JORGE L CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2104 GAUSE BLVD W, STE. A, SLIDELL, LA 70460-4130
(985) 643-4512
(985) 643-4513
Mailing address
2104 GAUSE BLVD W, STE. A, SLIDELL, LA 70460-4130
(985) 643-4512
(985) 643-4513
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD.201422
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508012
—
LA
Enumeration date
08/28/2007
Last updated
10/15/2015
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