Healthcare Provider Details

I. General information

NPI: 1326839366
Provider Name (Legal Business Name): FANNY RUIZ MS LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 N 23RD ST # 1047
MCALLEN TX
78501-6128
US

IV. Provider business mailing address

2215 N 23RD ST # 1047
MCALLEN TX
78501-6128
US

V. Phone/Fax

Practice location:
  • Phone: 956-400-3291
  • Fax:
Mailing address:
  • Phone: 956-400-3291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number97874
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: