Provider Demographics
NPI:1316597859
Name:SEGOVIA, RUBIA
Entity Type:Individual
Prefix:
First Name:RUBIA
Middle Name:
Last Name:SEGOVIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4634 SATURN RD APT 1515
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-6231
Mailing Address - Country:US
Mailing Address - Phone:972-800-4716
Mailing Address - Fax:
Practice Address - Street 1:4634 SATURN RD APT 1515
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-6231
Practice Address - Country:US
Practice Address - Phone:972-800-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications