Provider Demographics
| NPI: | 1144955022 |
|---|---|
| Name: | RUBINA VAZIR, LLC |
| Entity type: | Organization |
| Organization Name: | RUBINA VAZIR, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ON-SITE DOCTOR |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | GEORGE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | VALDEZ |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 281-255-2001 |
| Mailing Address - Street 1: | 204 W DALLAS ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CONROE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77301-1912 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 936-828-2334 |
| Mailing Address - Fax: | 936-828-2666 |
| Practice Address - Street 1: | 204 W DALLAS ST |
| Practice Address - Street 2: | |
| Practice Address - City: | CONROE |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77301-1912 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 936-828-2334 |
| Practice Address - Fax: | 936-828-2666 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-07-23 |
| Last Update Date: | 2022-08-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
| No | 174200000X | Other Service Providers | Meals | |
| No | 251J00000X | Agencies | Nursing Care | |
| No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
| No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
| No | 310500000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness | |
| No | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | |
| No | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility | |
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
| No | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility | |
| No | 315D00000X | Nursing & Custodial Care Facilities | Hospice, Inpatient | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 3336M0003X | Suppliers | Pharmacy | Managed Care Organization Pharmacy |
| No | 385H00000X | Respite Care Facility | Respite Care |
