Individual
RAUL RUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 S A W GRIMES BLVD, ROUND ROCK, TX 78664-7429
(512) 310-7665
Mailing address
1250 S A W GRIMES BLVD, ROUND ROCK, TX 78664-7429
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2079338
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUE CROSS BLUE SHIELD
TX
05
—
0944746-02
—
TX
Enumeration date
02/17/2012
Last updated
02/17/2012
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