Provider Demographics
NPI:1689100711
Name:RUAN, ALLEN (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:RUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YE
Other - Middle Name:
Other - Last Name:RUAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6684 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-5632
Practice Address - Country:US
Practice Address - Phone:254-899-4200
Practice Address - Fax:254-899-4205
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3866208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics