Provider Demographics
NPI:1679765036
Name:MARIO F. RUBIN, MD, PA
Entity type:Organization
Organization Name:MARIO F. RUBIN, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-825-0642
Mailing Address - Street 1:5917 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3129
Mailing Address - Country:US
Mailing Address - Phone:713-665-2783
Mailing Address - Fax:713-665-2269
Practice Address - Street 1:5917 LAKE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-3129
Practice Address - Country:US
Practice Address - Phone:713-665-2783
Practice Address - Fax:713-665-2269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty