MEDICARE: MCKENNA LEIGH RUIZ

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	146N00000X	Basic Emergency Medical Technician
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1831020635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENNA LEIGH RUIZ

Provider Business Mailing Address
First Line	:	103 MIKE ST
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-2819
Country	:	US
Telephone Number	:	806-777-7897
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 MIKE ST
Second Line	:
City	:	LEVELLAND
State	:	TX
Zip	:	79336-2819
Country	:	US
Telephone Number	:	806-777-7897
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ MCKENNA LEIGH RUIZ ” Practice Location

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