Provider Demographics
NPI:1912421876
Name:JUBRAN, SAMIA JO
Entity Type:Individual
Prefix:
First Name:SAMIA
Middle Name:JO
Last Name:JUBRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9919 CRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2641
Mailing Address - Country:US
Mailing Address - Phone:214-478-2333
Mailing Address - Fax:
Practice Address - Street 1:9919 CRESTWICK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2641
Practice Address - Country:US
Practice Address - Phone:214-478-2333
Practice Address - Fax:214-478-2333
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist