Provider Demographics
NPI:1518071216
Name:CHERIAN, RUBY (MD)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:CHERIAN
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 1:801 7TH AVE
Mailing Address - Street 2:REVENUE MANAGEMENT
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2733
Mailing Address - Country:US
Mailing Address - Phone:682-885-4157
Mailing Address - Fax:682-885-1903
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-1475
Practice Address - Fax:682-885-7520
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0080208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U87ZOtherBCBSTX GRP PIN
TX10025136OtherAMERIGROUP PIN
TX124102OtherSUPERIOR PIN
TX2002391OtherUHC PIN
TX2939279OtherCIGNA PIN
1750369203OtherGRP NPI NUMBER
TX1865969OtherFIRSTHEALTH PIN
TX7354175OtherAETNA PIN
TX88703GOtherBCBSTX IND PIN
TX2939279OtherCIGNA PIN
TX00L96BMedicare ID - Type UnspecifiedGRP MEDICARE
H27119Medicare UPIN