Ruben R Roncallo MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

K9162 Issued in TX

Legal business name

RUBEN R RONCALLO MD PA

Practice address

4500 N Mesa St
El Paso, TX 79912-6102

Phone

(915) 532-9000

NPI assigned

Apr 30, 2014

Organization subpart

No

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

Authorized official

Name

Edgardo Antonio Cera

Title

Manager

Phone

(915) 532-9000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1881004737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126102",
            "telephone_number": "915-532-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBEN R RONCALLO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "CERA",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "915-532-9000"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "K9162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101868104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valeria Ruan
• Elvira Rubalcava
• Ruben I Aguilar Professional Consulting Services Inc
• Ruben Moreno, LCSW, PC
• Ruben Ortiz Lsa LLC
• Lewis P Rubin, MD
• Maria Teresa Rubio-Pinaroc, M.D.
• Abril Rubio
• Carolyne Rubio
• Daniel Rubio, PA

• Primary Care Clinic/Center in El Paso, TX
• Providers in El Paso, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.