Individual provider Active NPI

Jorge Raul Ruiz, MPH, LVN

  • Licensed Vocational Nurse
  • Laredo, TX
National Provider Identifier
1336890524
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
157594 Issued in TX
Practice address
402 E Hillside Rd Ste 5
Laredo, TX 78041-3292
Phone
(956) 789-3749
NPI assigned
Jan 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 157594 TX Primary

Addresses

Primary practice location

402 E Hillside Rd Ste 5
Laredo, TX 78041-3292

Mailing address

306 Desert Chief Dr
Laredo, TX 78045-4178
Phone (956) 789-3749

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/a

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
157594TXMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1336890524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 DESERT CHIEF DR",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780454178",
            "telephone_number": "956-789-3749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E HILLSIDE RD STE 5",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780413292",
            "telephone_number": "956-789-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JORGE",
        "middle_name": "RAUL",
        "name_prefix": "Mr.",
        "credential": "MPH, LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "157594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/a",
            "affiliation": "N",
            "address_1": "402 E Hillside Rd Ste 5",
            "city": "Laredo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "780413292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.