MEDICARE: DR. RICARDO FRANKLIN URRUTIA 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	208000000X	Pediatrics Physician	F8712	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1942200092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICARDO FRANKLIN URRUTIA M.D.

Provider Business Mailing Address
First Line	:	523 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-8906
Fax Number	:	972-298-6896

Provider Business Practice Location Address
First Line	:	523 W WHEATLAND RD
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4515
Country	:	US
Telephone Number	:	972-298-8906
Fax Number	:	972-298-6896

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	07/02/2008

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