Provider Demographics
NPI:1811649338
Name:RUBESH, ELIZABETH (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:RUBESH
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23723 SAN BARRIA DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3047
Mailing Address - Country:US
Mailing Address - Phone:936-203-0772
Mailing Address - Fax:
Practice Address - Street 1:23723 SAN BARRIA DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3047
Practice Address - Country:US
Practice Address - Phone:936-203-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX936539163W00000X
TX1070700363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner