Healthcare Provider Details

I. General information

NPI: 1013719178
Provider Name (Legal Business Name): FRANCISCO JAVIER RUIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GUTIERREZ 2807
NUEVO LAREDO TAMAULIPAS
88000
MX

IV. Provider business mailing address

1014 ROE DR
LAREDO TX
78045-7181
US

V. Phone/Fax

Practice location:
  • Phone: 956-284-9415
  • Fax:
Mailing address:
  • Phone: 956-401-6251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11794002
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: