Provider Demographics
NPI:1053453555
Name:UBINAS, EMMANUEL EDGUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:EDGUARDO
Last Name:UBINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-824-7373
Mailing Address - Fax:214-826-7373
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:SUITE 2000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-824-7373
Practice Address - Fax:214-826-7373
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7732174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G616Medicare ID - Type UnspecifiedPROVIDER NUMBER