Provider Demographics
NPI:1346299872
Name:RABJOHN, LINNIE VIRGINIA (DPM)
Entity Type:Individual
Prefix:MS
First Name:LINNIE
Middle Name:VIRGINIA
Last Name:RABJOHN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:400 W ARBROOK BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3176
Mailing Address - Country:US
Mailing Address - Phone:817-467-1990
Mailing Address - Fax:817-466-8737
Practice Address - Street 1:515 W MAYFIELD RD
Practice Address - Street 2:SUITE 407
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2083
Practice Address - Country:US
Practice Address - Phone:817-467-1990
Practice Address - Fax:817-466-8737
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1783213E00000X
PASC005667213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K0131OtherBCBS
8G7444Medicare PIN
V09759Medicare UPIN
TX0889900002Medicare NSC