Provider Demographics
NPI:1972727154
Name:JOE, RUBY (LVN)
Entity type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:
Last Name:JOE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 FIELD VIEW LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75249-1112
Mailing Address - Country:US
Mailing Address - Phone:972-283-8931
Mailing Address - Fax:817-334-0249
Practice Address - Street 1:700 HEMPHILL ST
Practice Address - Street 2:SUITE A
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3105
Practice Address - Country:US
Practice Address - Phone:817-334-0111
Practice Address - Fax:817-334-0249
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47246164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse