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NPI Code Detail

MEDICARE: RUBY RODRIGUEZ O.D.

MEDICARE: RUBY RODRIGUEZ 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
1152W00000XOptometristT-207-TA-920AL
2152W00000XOptometrist8031TGTX

General Provider Information

NPI Number : 1831459973
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBY RODRIGUEZ O.D.
Provider Business Mailing Address
First Line : 1950 OLD GALLOWS RD STE 520
Second Line :
City : VIENNA
State : VA
Zip : 22182-3970
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 1905 ABRAMS RD
Second Line :
City : DALLAS
State : TX
Zip : 75214-3916
Country : US
Telephone Number : 214-821-2020
Fax Number : 214-821-2025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2012
Last Update Date : 10/20/2020

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Directions to “ RUBY RODRIGUEZ O.D.” Practice Location

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