Provider Demographics
NPI:1346247301
Name:RUPLEY, MARCELINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELINA
Middle Name:
Last Name:RUPLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-782-0097
Practice Address - Street 1:416 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-4162
Practice Address - Country:US
Practice Address - Phone:806-761-0536
Practice Address - Fax:806-761-0537
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2771208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1379281-12Medicaid
1447372123OtherGROUP TX HEALTHSTEP NPI
TX183956502OtherGROUP MEDICAID TXHEALTHSTEP
TX00J21AOtherMEDICARE GROUP NUMBER
1083752059OtherGROUP NPI
TX137928106Medicaid
TX183956501OtherGROUP MEDICAID
TX137928101Medicaid
TX137928115Medicaid
TXF31528Medicare UPIN