MEDICARE: MISS RUBY AGRAWAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	021896	TX
2	372600000X	Adult Companion

General Provider Information

NPI Number	:	1013622802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RUBY AGRAWAL

Provider Business Mailing Address
First Line	:	7026 HABERSHAM AVE
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-5792
Country	:	US
Telephone Number	:	281-221-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 INDUSTRIAL BLVD STE 3002
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-2601
Country	:	US
Telephone Number	:	281-221-1828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2023
Last Update Date	:	04/11/2023

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Directions to “ MISS RUBY AGRAWAL ” Practice Location

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