Healthcare Provider Details

I. General information

NPI: 1790654358
Provider Name (Legal Business Name): CLAUDIA PALMA RUBIN DE CELIS CCHI AND JBCC LCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 REAL WIND CV
AUSTIN TX
78746-2124
US

IV. Provider business mailing address

1803 REAL WIND CV
AUSTIN TX
78746-2124
US

V. Phone/Fax

Practice location:
  • Phone: 512-466-5805
  • Fax:
Mailing address:
  • Phone: 512-466-5805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number2349
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: