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NPI Code Detail

MEDICARE: ELIZABETH RUBERG

MEDICARE: ELIZABETH RUBERG
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
1363LF0000XFamily Nurse Practitioner1021651TX

General Provider Information

NPI Number : 1720757842
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH RUBERG
Provider Business Mailing Address
First Line : 6306 FAIRBANKS N HOUSTON RD STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77040-5193
Country : US
Telephone Number : 832-831-9094
Fax Number :
Provider Business Practice Location Address
First Line : 6306 FAIRBANKS N HOUSTON RD STE 500
Second Line :
City : HOUSTON
State : TX
Zip : 77040-5193
Country : US
Telephone Number : 512-762-9876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2021
Last Update Date : 11/11/2021

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Directions to “ ELIZABETH RUBERG ” Practice Location

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