MEDICARE: JOSUE RUIZ FITTER/DISPENSER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	80422	TX

General Provider Information

NPI Number	:	1235493917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSUE RUIZ FITTER/DISPENSER

Provider Business Mailing Address
First Line	:	6810 ARROW WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2302
Country	:	US
Telephone Number	:	210-375-4949
Fax Number	:	210-375-3045

Provider Business Practice Location Address
First Line	:	6810 ARROW WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78256-2302
Country	:	US
Telephone Number	:	210-375-4949
Fax Number	:	210-375-3045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	06/27/2012

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Directions to “ JOSUE RUIZ FITTER/DISPENSER” Practice Location

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