MEDICARE: JOSEPH R. RAUB, JR., D.M.D., M.SC.D., P.A.

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	1223P0221X	Pediatric Dentistry	18253	TX

General Provider Information

NPI Number	:	1588783880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH R. RAUB, JR., D.M.D., M.SC.D., P.A.

Provider Business Mailing Address
First Line	:	PO BOX 3280
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76505-3280
Country	:	US
Telephone Number	:	254-771-5701
Fax Number	:	254-771-5770

Provider Business Practice Location Address
First Line	:	2122 BIRDCREEK DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1020
Country	:	US
Telephone Number	:	254-771-5701
Fax Number	:	254-771-5770

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH REYNOLDS RAUB
Credential	:
Telephone Number	:	254-771-5701

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/22/2020

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