Provider Demographics
NPI:1295980803
Name:JUDITH E RUBIN D P M P C
Entity type:Organization
Organization Name:JUDITH E RUBIN D P M P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM , PA
Authorized Official - Phone:281-955-5500
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:77429-4695
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:77429-4695
Practice Address - Country:US
Practice Address - Phone:281-955-5500
Practice Address - Fax:281-890-9365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0815213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty