Healthcare Provider Details

I. General information

NPI: 1184725483
Provider Name (Legal Business Name): NORMA RUANO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/07/2023
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 N VETERANS BLVD
EAGLE PASS TX
78852-3302
US

IV. Provider business mailing address

PO BOX 1470
EAGLE PASS TX
78853-1470
US

V. Phone/Fax

Practice location:
  • Phone: 830-773-4557
  • Fax: 830-773-0328
Mailing address:
  • Phone: 830-773-8917
  • Fax: 830-773-1892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number14987
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number14987
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: