Provider Demographics
NPI:1346247301
Name:RUPLEY, MARCELINA (MD)
Entity type:Individual
Prefix:DR
First Name:MARCELINA
Middle Name:
Last Name:RUPLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 N VIRGINIA ST
Mailing Address - Street 2:
Mailing Address - City:PORT LAVACA
Mailing Address - State:TX
Mailing Address - Zip Code:77979-3000
Mailing Address - Country:US
Mailing Address - Phone:361-552-0325
Mailing Address - Fax:361-500-6904
Practice Address - Street 1:1016 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-3000
Practice Address - Country:US
Practice Address - Phone:361-552-0325
Practice Address - Fax:361-500-6904
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2771208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1379281-12Medicaid
TX137928115Medicaid
TX183956501OtherGROUP MEDICAID
TX183956502OtherGROUP MEDICAID TXHEALTHSTEP
1083752059OtherGROUP NPI
TX137928101Medicaid
TX137928106Medicaid
1447372123OtherGROUP TX HEALTHSTEP NPI
TX00J21AOtherMEDICARE GROUP NUMBER
TXF31528Medicare UPIN