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NPI Code Detail

MEDICARE: DR. RUTH A BERNARDEZ-TAN M.D.

MEDICARE: DR. RUTH A BERNARDEZ-TAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianJ8913TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598709149
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUTH A BERNARDEZ-TAN M.D.
Provider Business Mailing Address
First Line : 1915 E MAYFIELD RD STE 115
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2605
Country : US
Telephone Number : 682-276-6700
Fax Number : 682-276-6049
Provider Business Practice Location Address
First Line : 1915 E MAYFIELD RD STE 115
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2605
Country : US
Telephone Number : 682-276-6700
Fax Number : 682-276-6049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 11/30/2023

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