Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | BP10067737 | TX |
NPI | 1053963389 |
---|---|
Provider Name | Ruba Riachy |
First Address | Galveston, TX 77555 |
Second Address | Galveston, TX 77555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2019 |
Last Update Date | 16/07/2019 |