MEDICARE: SABRINA LEE RUBIO O.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	152W00000X	Optometrist	5452T	TX

General Provider Information

NPI Number	:	1316939663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA LEE RUBIO O.D.

Provider Business Mailing Address
First Line	:	12030 BANDERA RD
Second Line	:	SUITE 112
City	:	HELOTES
State	:	TX
Zip	:	78023-4735
Country	:	US
Telephone Number	:	210-509-9998
Fax Number	:	210-509-4272

Provider Business Practice Location Address
First Line	:	12030 BANDERA RD
Second Line	:	SUITE 112
City	:	HELOTES
State	:	TX
Zip	:	78023-4735
Country	:	US
Telephone Number	:	210-509-9998
Fax Number	:	210-509-4272

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	12/02/2016

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