Provider Demographics
NPI:1437811031
Name:XHEMALAJ, RUBENS (OD)
Entity Type:Individual
Prefix:DR
First Name:RUBENS
Middle Name:
Last Name:XHEMALAJ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8638 HUEBNER RD APT 1326
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2473
Mailing Address - Country:US
Mailing Address - Phone:440-251-4215
Mailing Address - Fax:
Practice Address - Street 1:2019 ANDERSON RD STE C
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0773
Practice Address - Country:US
Practice Address - Phone:530-756-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35050152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist