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General NPI Number Information
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NPI Number | 1528056736
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Entity Type | Individual
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Provider Name | ROBERT ALAN RUCHINSKAS PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 5323 HARRY HINNES BLVD.
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City | DALLAS
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State | TX
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Zip | 75390-7208
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Country | US
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Telephone | 214-648-4646
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Fax | 214-648-4947
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Provider Business Mailing Address
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Address Line | 1440 EMPIRE CENTRAL
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City | DALLAS
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State | TX
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Zip | 75247
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Country | US
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Telephone | 214-648-4646
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Fax | 214-648-4947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 36074
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PA007810L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI00457100
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 36074
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License Number State | TX
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