Provider Demographics
NPI:1790746824
Name:RUBIN, JUDITH EVE (DPM)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:EVE
Last Name:RUBIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1439
Mailing Address - Country:US
Mailing Address - Phone:281-955-5500
Mailing Address - Fax:281-890-9365
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 240
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1439
Practice Address - Country:US
Practice Address - Phone:281-955-5500
Practice Address - Fax:281-890-9365
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0815213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SD60OtherBCBS
TX0188211-01Medicaid
TX0815OtherLICENSE
TX0188211-01Medicaid