Provider Demographics
NPI:1043922867
Name:RUBIO ESPINOZA, ANGELO PAOLO
Entity Type:Individual
Prefix:
First Name:ANGELO PAOLO
Middle Name:
Last Name:RUBIO ESPINOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4489 COUNTY ROAD 94
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3078
Mailing Address - Country:US
Mailing Address - Phone:281-692-9728
Mailing Address - Fax:
Practice Address - Street 1:4489 COUNTY ROAD 94
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3078
Practice Address - Country:US
Practice Address - Phone:281-692-9728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-23
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73746183500000X
CATCH174866183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician