Provider Demographics
NPI:1043420524
Name:RUBIO-PINAROC, MARIA TERESA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:
Last Name:RUBIO-PINAROC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:RUBIO PINAROC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 961509
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79996-1509
Mailing Address - Country:US
Mailing Address - Phone:915-613-3741
Mailing Address - Fax:915-594-0566
Practice Address - Street 1:11548 VISTA DEL SOL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-613-3741
Practice Address - Fax:915-594-0566
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154040301Medicaid
TX0022JLOtherBLUE CROSS BLUE SHIELD TX
TX154041101Medicaid
TX1710978572OtherNPI GROUP
TX5916252OtherAETNA
TX154040301Medicaid
TX8A0578Medicare ID - Type UnspecifiedINDIVIDUAL
TX00328UMedicare ID - Type UnspecifiedGROUP
TX154041101Medicaid