Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 12592 | CA |
NPI | 1033470158 |
---|---|
Provider Name | Raubby Sabalerio |
First Address | Austin, TX 78756-3101 |
Second Address | Austin, TX 78756-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 18/11/2017 |