Provider Demographics
NPI:1871528752
Name:RUBLEE, WILLIAM R (DC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:RUBLEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W CALTON RD
Mailing Address - Street 2:STE 107
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6630
Mailing Address - Country:US
Mailing Address - Phone:956-712-1444
Mailing Address - Fax:956-712-2287
Practice Address - Street 1:502 W CALTON RD
Practice Address - Street 2:STE 107
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6630
Practice Address - Country:US
Practice Address - Phone:956-712-1444
Practice Address - Fax:956-712-2287
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4029111N00000X
TXMT035182225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC06014089Medicaid
TXC06014089Medicaid
TXT15664Medicare UPIN