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General NPI Number Information
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NPI Number | 1609724491
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Entity Type | Individual
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Provider Name | AMANDA RUBAC
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Gender | Female
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 602 N MAIN ST UNIT D
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City | ROCKDALE
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State | TX
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Zip | 76567-2393
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Country | US
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Telephone | 512-446-2277
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Fax | 833-645-0445
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Provider Business Mailing Address
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Address Line | 199 COUNTY ROAD 263 LOOP
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City | CAMERON
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State | TX
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Zip | 76520
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1229316
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License Number State | TX
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