Provider Demographics
NPI:1861975401
Name:MIDDLETON, RUKIYA (NP)
Entity type:Individual
Prefix:
First Name:RUKIYA
Middle Name:
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 SAN SIMEON DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3286
Mailing Address - Country:US
Mailing Address - Phone:832-867-1828
Mailing Address - Fax:
Practice Address - Street 1:2510 SMITH RANCH RD STE 102
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5209
Practice Address - Country:US
Practice Address - Phone:346-439-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135873363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRUKIYA88Medicaid