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General NPI Number Information
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NPI Number | 1720261159
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Entity Type | Organization
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Legal Business Name | RUBIO CHIROPRACTIC PA
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2928 INWOOD RD
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City | DALLAS
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State | TX
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Zip | 75235-7518
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Country | US
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Telephone | 214-654-0636
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Fax | 214-654-0636
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Provider Business Mailing Address
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Address Line | PO BOX 35328
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City | DALLAS
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State | TX
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Zip | 75235-0328
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Country | US
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Telephone | 214-654-0636
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Fax | 214-654-0637
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Authorized Official
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Title or Position | PROPRIETOR
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Name | TOM RUBIO IV
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Credential | DC
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Telephone | 214-654-0636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6007
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License Number State | TX
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