Provider Demographics
NPI:1457391062
Name:REUBEN, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:REUBEN
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:PO BOX 770248
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77215-0248
Mailing Address - Country:US
Mailing Address - Phone:713-521-7870
Mailing Address - Fax:713-521-7919
Practice Address - Street 1:4126 SOUTHWEST FWY
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7310
Practice Address - Country:US
Practice Address - Phone:713-521-7870
Practice Address - Fax:713-521-7919
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3152207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135844202Medicaid
TXX17676Medicare UPIN
TX135844202Medicaid