MEDICARE: DR. JUSTINA PEPPLE TAUBE M.D.

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	207W00000X	Ophthalmology Physician	J4553	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	J4553	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
2	8W4460	OTHER		BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1922113505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTINA PEPPLE TAUBE M.D.

Provider Business Mailing Address
First Line	:	25410 I-45 NORTH
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1351
Country	:	US
Telephone Number	:	281-367-1414
Fax Number	:	281-363-5686

Provider Business Practice Location Address
First Line	:	25410 I-45 NORTH FWY
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1351
Country	:	US
Telephone Number	:	281-367-1414
Fax Number	:	281-363-5686

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	08/25/2015

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