Provider Demographics
NPI:1407982796
Name:HOWARD A. RUBIN, MD, PA
Entity Type:Organization
Organization Name:HOWARD A. RUBIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-386-9600
Mailing Address - Street 1:12890 HILLCREST RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1504
Mailing Address - Country:US
Mailing Address - Phone:972-386-9600
Mailing Address - Fax:972-386-9994
Practice Address - Street 1:12890 HILLCREST RD
Practice Address - Street 2:SUITE 203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1504
Practice Address - Country:US
Practice Address - Phone:972-386-9600
Practice Address - Fax:972-386-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6566207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH6566OtherLICENSE NUMBER
TXP000R15E8Medicaid
TXH6566OtherLICENSE NUMBER
TXF29577Medicare UPIN