Provider Demographics
NPI:1184702367
Name:CRUZ, CARLOS (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 MCPHERSON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6382
Mailing Address - Country:US
Mailing Address - Phone:956-726-9905
Mailing Address - Fax:956-726-3330
Practice Address - Street 1:8607 MCPHERSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6382
Practice Address - Country:US
Practice Address - Phone:956-726-9905
Practice Address - Fax:956-726-3330
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8062207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81H868Medicare ID - Type Unspecified
TXF33095Medicare UPIN