Provider Demographics
NPI:1568653798
Name:BASHIR, RUBIN S (MD)
Entity Type:Individual
Prefix:
First Name:RUBIN
Middle Name:S
Last Name:BASHIR
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 1:6620 MAIN ST
Mailing Address - Street 2:SUITE 1325
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2348
Mailing Address - Country:US
Mailing Address - Phone:713-986-5630
Mailing Address - Fax:713-986-5731
Practice Address - Street 1:6620 MAIN ST
Practice Address - Street 2:SUITE 13525
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2348
Practice Address - Country:US
Practice Address - Phone:713-986-5630
Practice Address - Fax:713-986-5731
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99367207XS0117X
TXM9835207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BX405OtherBC/BS
TX8BX405OtherBC/BS
TXTXB112910Medicare PIN
TX8F20736Medicare PIN