Provider Demographics
NPI:1558669663
Name:LUBIN, SHIANE MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:SHIANE
Middle Name:MARIE
Last Name:LUBIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SHAIANE
Other - Middle Name:MARIE
Other - Last Name:MOFFITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:215 OAK DR S STE F
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 OAK DR S STE F
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5617
Practice Address - Country:US
Practice Address - Phone:979-299-1520
Practice Address - Fax:979-299-1421
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80663237600000X
TX80633231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter