MEDICARE: MRS. MUBARAKA RUPAWALLA B.S.

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	225XP0200X	Pediatric Occupational Therapist	108401	TX

General Provider Information

NPI Number	:	1518142025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MUBARAKA RUPAWALLA B.S.

Provider Business Mailing Address
First Line	:	6361 S STADIUM LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1057
Country	:	US
Telephone Number	:	832-260-2744
Fax Number	:

Provider Business Practice Location Address
First Line	:	6361 S STADIUM LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1057
Country	:	US
Telephone Number	:	281-237-6647
Fax Number	:	281-644-1846

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	06/19/2024

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