Basic Information
| Provider Information | |||||||||
| NPI: | 1760545875 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUFFIER | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | ANDREA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11220 ROJAS | ||||||||
| Address2: | STE C-4 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9158559333 | ||||||||
| FaxNumber: | 9158559213 | ||||||||
| Practice Location | |||||||||
| Address1: | 11220 ROJAS | ||||||||
| Address2: | STE C-4 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9158559333 | ||||||||
| FaxNumber: | 9158559213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 01/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 251E00000X | 012899 | TX | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 72102772 | 05 | NM | MEDICAID |