MEDICARE: DR. DAVID R RUIZ-BELLO M.D.

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	207R00000X	Internal Medicine Physician	N1114	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01080712	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770732398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID R RUIZ-BELLO M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-1205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-740-8516

Provider Business Practice Location Address
First Line	:	2821 LACKLAND ROAD, SUITE 216
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-4193
Country	:	US
Telephone Number	:	817-378-3640
Fax Number	:	817-740-8516

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

Provider Enumeration Date	:	09/18/2008
Last Update Date	:	10/25/2012

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Directions to “ DR. DAVID R RUIZ-BELLO M.D.” Practice Location

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