Provider Demographics
NPI:1841961190
Name:RUEBENSPN, DONALD G III (IDHS)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:G
Last Name:RUEBENSPN
Suffix:III
Gender:M
Credentials:IDHS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 WALLACE REED RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78597-6401
Mailing Address - Country:US
Mailing Address - Phone:956-364-7400
Mailing Address - Fax:956-364-7402
Practice Address - Street 1:1 WALLACE REED RD
Practice Address - Street 2:
Practice Address - City:SOUTH PADRE ISLAND
Practice Address - State:TX
Practice Address - Zip Code:78597-6401
Practice Address - Country:US
Practice Address - Phone:956-364-7400
Practice Address - Fax:956-364-7402
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman