Healthcare Provider Details

I. General information

NPI: 1053027938
Provider Name (Legal Business Name): RUBINA PINA-SHELTON LPC, MED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 COMMERCIAL CIR STE 807
CONROE TX
77304-3822
US

IV. Provider business mailing address

PO BOX 543
GOODRICH TX
77335-0543
US

V. Phone/Fax

Practice location:
  • Phone: 832-304-3366
  • Fax:
Mailing address:
  • Phone: 832-318-7431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number90433
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: