Individual
MAURA RUBY RONQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 W 38TH ST, SUITE 705, AUSTIN, TX 78705-1000
(575) 650-6415
Mailing address
1301 W 38TH ST, SUITE 705, AUSTIN, TX 78705-1000
(575) 650-6415
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
506718538
NM
207V00000X
Obstetrics & Gynecology Physician
Primary
T0612
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10059760
BASIC POST GRADUATE TRAINING PERMIT
TX
Enumeration date
05/11/2017
Last updated
12/15/2021
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