Provider Demographics
NPI:1386206472
Name:RUBY SHOES PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:RUBY SHOES PSYCHIATRY PLLC
Other - Org Name:BLUEBIRD PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-585-1217
Mailing Address - Street 1:510 HEARN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4516
Mailing Address - Country:US
Mailing Address - Phone:512-521-0868
Mailing Address - Fax:512-521-0868
Practice Address - Street 1:510 HEARN ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4516
Practice Address - Country:US
Practice Address - Phone:512-521-0868
Practice Address - Fax:512-521-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty