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General NPI Number Information
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NPI Number | 1619383056
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Entity Type | Individual
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Provider Name | DOUNGPORN RUTHIRAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 3601 4TH ST STOP 8321 DEPARTMENT OF NEUROLOGY
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City | LUBBOCK
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State | TX
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Zip | 79430-8321
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Country | US
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Telephone | 806-743-3832
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 4TH ST STOP 8321 DEPARTMENT OF NEUROLOGY
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City | LUBBOCK
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State | TX
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Zip | 79430-5363
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Country | US
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Telephone | 806-743-3832
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | BP10049571
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License Number State | TX
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