Provider Demographics
NPI:1861154833
Name:TARIO, RUBY ALEJANDRA
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:ALEJANDRA
Last Name:TARIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 PACKARD ELM ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77038-2653
Mailing Address - Country:US
Mailing Address - Phone:281-986-0932
Mailing Address - Fax:
Practice Address - Street 1:2734 PACKARD ELM ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77038-2653
Practice Address - Country:US
Practice Address - Phone:281-986-0932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHWC9L73AWMedicaid