=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003730565
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JORGE A RUIZ GUERRA DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2026
-----------------------------------------------------
Last Update Date | 08/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14015 UNIVERSITY PASS APT 1409
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78249-4742
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-575-2982
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3981 HUNTER CREEK DR
-----------------------------------------------------
City | COLLEGE STATION
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77845-9321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-575-2982
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 3134516
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------