Provider Demographics
NPI:1023368651
Name:TOVA RUBIN PHD PC
Entity Type:Organization
Organization Name:TOVA RUBIN PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRACHA
Authorized Official - Middle Name:TOVA
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-697-1600
Mailing Address - Street 1:PO BOX 781221
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-1221
Mailing Address - Country:US
Mailing Address - Phone:210-697-1600
Mailing Address - Fax:210-493-6714
Practice Address - Street 1:11503 NW MILITARY HWY
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1884
Practice Address - Country:US
Practice Address - Phone:210-697-1660
Practice Address - Fax:210-493-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty