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General NPI Number Information
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NPI Number | 1285066381
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Entity Type | Organization
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Legal Business Name | JORGE RUIZ LLANES MD PA
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 12/26/2013
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Provider Practice Location Address
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Address Line | 1412 E 8TH ST SUITE-B
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City | WESLACO
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State | TX
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Zip | 78596-6639
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Country | US
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Telephone | 956-647-5144
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Fax | 956-647-5145
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Provider Business Mailing Address
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Address Line | PO BOX 8006
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City | WESLACO
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State | TX
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Zip | 78599-8006
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Country | US
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Telephone | 956-647-5144
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Fax | 956-647-5145
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORGE RUIZ LLANES
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Credential | MD
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Telephone | 956-647-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M8300
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License Number State | FL
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