Provider Demographics
NPI:1265679625
Name:CARUBBA, DIANA EMILIA (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:EMILIA
Last Name:CARUBBA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DIANA
Other - Middle Name:EMILIA
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:130 UPTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-7559
Mailing Address - Country:US
Mailing Address - Phone:956-621-4946
Mailing Address - Fax:956-621-4950
Practice Address - Street 1:130 UPTOWN AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-621-4946
Practice Address - Fax:956-621-4950
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217752903Medicaid
TX320770601Medicaid
DU3702OtherRAILROAD MEDICARE