Individual
LOU A. RABURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 TEXAS AVE, BRIDGE CITY, TX 77611-3530
(409) 735-2930
(409) 735-4513
Mailing address
1615 TEXAS AVE, BRIDGE CITY, TX 77611-3530
(409) 735-2930
(409) 735-4513
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519608
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/01/2006
Last updated
07/08/2007
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