MEDICARE: DR. ALLEN W RUBIN M.D.

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	207RG0100X	Gastroenterology Physician	E2338	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89Y242	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215913173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN W RUBIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 35629
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0629
Country	:	US
Telephone Number	:	214-424-2213
Fax Number	:	214-231-2159

Provider Business Practice Location Address
First Line	:	701 TUSCAN
Second Line	:	SUITE #110
City	:	IRVING
State	:	TX
Zip	:	75039-3834
Country	:	US
Telephone Number	:	214-496-1100
Fax Number	:	214-496-1110

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	05/16/2013

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