MEDICARE: MS. ROSE MARY RUBIO SOCIAL WORKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	O1947	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588863302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSE MARY RUBIO SOCIAL WORKER

Provider Business Mailing Address
First Line	:	185 UNION CHAPEL RD
Second Line	:
City	:	CEDAR CREEK
State	:	TX
Zip	:	78612-3111
Country	:	US
Telephone Number	:	512-985-6169
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 UNION CHAPEL RD
Second Line	:
City	:	CEDAR CREEK
State	:	TX
Zip	:	78612-3111
Country	:	US
Telephone Number	:	512-985-6169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	07/12/2007

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