Provider Demographics
NPI:1568477321
Name:CIUBUC, RADU I (MD)
Entity Type:Individual
Prefix:
First Name:RADU
Middle Name:I
Last Name:CIUBUC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001EN MESA ST 320
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1627
Mailing Address - Country:US
Mailing Address - Phone:915-217-2163
Mailing Address - Fax:915-217-2166
Practice Address - Street 1:125 W HAGUE RD STE 130
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5814
Practice Address - Country:US
Practice Address - Phone:915-217-2163
Practice Address - Fax:915-217-2166
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0685207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037540408Medicaid
TX037540409Medicaid
TX037540407Medicaid
NM68485077Medicaid
TX037540410Medicaid
TX8E0314Medicare PIN
TXG36865Medicare UPIN
TX8F23369Medicare PIN
TX037540409Medicaid