MEDICARE: RUBI SHAMSI ANJUM RDN, LD

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	133V00000X	Registered Dietitian	DT80546	TX

General Provider Information

NPI Number	:	1346503166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBI SHAMSI ANJUM RDN, LD

Provider Business Mailing Address
First Line	:	13892 KEVIN DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-6283
Country	:	US
Telephone Number	:	972-379-8832
Fax Number	:	214-937-3686

Provider Business Practice Location Address
First Line	:	6010 W SPRING CREEK PKWY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-3569
Country	:	US
Telephone Number	:	972-379-8832
Fax Number	:	214-937-3686

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

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	09/14/2022

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