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General NPI Number Information
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NPI Number | 1609184555
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Entity Type | Organization
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Legal Business Name | ALBERTO R DE LA CRUZ MD PA
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 719 W COKE RD STE.7
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City | WINNSBORO
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State | TX
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Zip | 75494-3011
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Country | US
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Telephone | 903-342-4242
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Fax | 903-342-4055
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Provider Business Mailing Address
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Address Line | 719 W COKE RD STE.7
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City | WINNSBORO
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State | TX
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Zip | 75494-3011
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Country | US
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Telephone | 903-342-4242
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Fax | 903-342-4055
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERTO R DE LA CRUZ
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Credential | MD
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Telephone | 903-342-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | F7443
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License Number State | TX
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