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NPI Code Detail

MEDICARE: CHARLIE RUBY D O P A

MEDICARE: CHARLIE RUBY D O 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
1207Q00000XFamily Medicine PhysicianL0917TX

General Provider Information

NPI Number : 1780850099
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLIE RUBY D O P A
Provider Business Mailing Address
First Line : PO BOX 270
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-0270
Country : US
Telephone Number : 972-723-5590
Fax Number : 972-723-5592
Provider Business Practice Location Address
First Line : 4440 E HIGHWAY 287
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5576
Country : US
Telephone Number : 972-723-5590
Fax Number : 972-723-5592
Authorized Official
Title or Position : PHYSICIAN
Name : DR. EARL CHARLIE RUBY
Credential : D. O.
Telephone Number : 972-723-5590
Provider Enumeration Date : 05/06/2008
Last Update Date : 08/26/2008

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Directions to “CHARLIE RUBY D O P A ” Practice Location

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