MEDICARE: CLARISSA LAURA RUIZ PA

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1265122683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARISSA LAURA RUIZ PA

Provider Business Mailing Address
First Line	:	1700 W DOVE AVE STE 20
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-4464
Country	:	US
Telephone Number	:	956-704-9192
Fax Number	:	956-615-8904

Provider Business Practice Location Address
First Line	:	1700 W DOVE AVE STE 20
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-4464
Country	:	US
Telephone Number	:	956-704-9192
Fax Number	:

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

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	04/22/2026

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Directions to “ CLARISSA LAURA RUIZ PA” Practice Location

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