Individual
DR. JODY ALAN RUBENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5418 MORNINGSIDE AVE, DALLAS, TX 75206-5840
(214) 206-6473
Mailing address
5418 MORNINGSIDE AVE, DALLAS, TX 75206-5840
(214) 206-6473
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2-4753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352153601
—
TX
01
—
352153602
CSHCN MEDICAID
TX
01
—
89455A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/17/2006
Last updated
03/21/2016
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