Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 573482 | TX |
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP112360 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 573482 | TX |
NPI | 1376622993 |
---|---|
Provider Name | Paula Kay Rupert |
First Address | Houston, TX 77030-2717 |
Second Address | Houston, TX 77030-2717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 17/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
162821601 | (05) | TX |
162821602 | (05) | TX |
162821604 | (05) | TX |
8Y3537 | BCBS (01) | TX |
8Y3537 | BLUE CROSS BLUE SHIELD (01) | TX |
P00936708 | MEDICARE RR (01) | TX |
P01186479 | RR MEDICARE (01) | TX |
Q02182 | (02) | TX |