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General NPI Number Information
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NPI Number | 1194437459
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Entity Type | Individual
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Provider Name | SARA MARIE RUBIO APRN CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 9410 NE ZAC LENTZ PKWY STE 202
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City | VICTORIA
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State | TX
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Zip | 77904-3172
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Country | US
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Telephone | 361-579-1333
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Fax | 361-579-1334
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Provider Business Mailing Address
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Address Line | 56 SADDLEHORN DR
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City | PORT LAVACA
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State | TX
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Zip | 77979-5234
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Country | US
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Telephone | 361-676-6977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 1097691
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License Number State | TX
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