Provider Demographics
NPI:1194437459
Name:RUBIO, SARA MARIE (APRN CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:RUBIO
Suffix:
Gender:F
Credentials:APRN CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:56 SADDLEHORN DR
Mailing Address - Street 2:
Mailing Address - City:PORT LAVACA
Mailing Address - State:TX
Mailing Address - Zip Code:77979-5234
Mailing Address - Country:US
Mailing Address - Phone:361-676-6977
Mailing Address - Fax:
Practice Address - Street 1:9410 NE ZAC LENTZ PKWY STE 202
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3172
Practice Address - Country:US
Practice Address - Phone:361-579-1333
Practice Address - Fax:361-579-1334
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097691363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics