MEDICARE: ADRIANA RUIZ-DAMON

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
1	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1639631971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA RUIZ-DAMON

Provider Business Mailing Address
First Line	:	4618 SW LOOP 820
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4400
Country	:	US
Telephone Number	:	682-597-3109
Fax Number	:	817-763-9994

Provider Business Practice Location Address
First Line	:	4618 SW LOOP 820
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4400
Country	:	US
Telephone Number	:	682-597-3109
Fax Number	:	817-763-9994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	04/04/2019

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