Healthcare Provider Details

I. General information

NPI: 1962210302
Provider Name (Legal Business Name): ALIYA RUBIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 N CENTRAL EXPY
RICHARDSON TX
75080-2712
US

IV. Provider business mailing address

11803 WESTHEIMER RD STE 720
HOUSTON TX
77077-6796
US

V. Phone/Fax

Practice location:
  • Phone: 214-453-4533
  • Fax:
Mailing address:
  • Phone: 832-810-9021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20287
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: