Provider Demographics
NPI:1275014896
Name:RUBIO, BRYON ADAM
Entity Type:Individual
Prefix:
First Name:BRYON
Middle Name:ADAM
Last Name:RUBIO
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 1:12410 ALAMEDA TRACE CIR APT 2036
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6375
Mailing Address - Country:US
Mailing Address - Phone:512-400-8000
Mailing Address - Fax:
Practice Address - Street 1:12410 ALAMEDA TRACE CIR APT 2036
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78727-6375
Practice Address - Country:US
Practice Address - Phone:512-400-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX372442355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant