Basic Information
| Provider Information | |||||||||
| NPI: | 1184688608 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBANO | ||||||||
| FirstName: | JUDITH | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1533 S BROWNLEE BLVD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784043131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618842242 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1533 S BROWNLEE BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784043131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3618842242 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2006 | ||||||||
| LastUpdateDate: | 10/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | S6501 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 15556 | SC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.