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NPI Code Detail

MEDICARE: RUTH ELIZALDE

MEDICARE:   RUTH  ELIZALDE
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
12355S0801XSpeech-Language Assistant36877TX

General Provider Information

NPI Number : 1629558077
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH ELIZALDE
Provider Business Mailing Address
First Line : 6800 GATEWAY BLVD E STE 4A
Second Line :
City : EL PASO
State : TX
Zip : 79915-1006
Country : US
Telephone Number : 915-779-7827
Fax Number :
Provider Business Practice Location Address
First Line : 6800 GATEWAY BLVD E STE 4A
Second Line :
City : EL PASO
State : TX
Zip : 79915-1006
Country : US
Telephone Number : 915-779-7827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2018
Last Update Date : 08/15/2018

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Directions to “ RUTH ELIZALDE ” Practice Location

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