Dr Marcelina Rupley, MD | |
1016 N Virginia St, Port Lavaca, TX 77979-3000 | |
(361) 552-0325 | |
(361) 500-6904 |
Full Name | Dr Marcelina Rupley |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1016 N Virginia St, Port Lavaca, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346247301 | NPI | - | NPPES |
1379281-12 | Medicaid | TX | |
137928115 | Medicaid | TX | |
183956501 | Other | TX | GROUP MEDICAID |
183956502 | Other | TX | GROUP MEDICAID TXHEALTHSTEP |
1083752059 | Other | GROUP NPI | |
137928101 | Medicaid | TX | |
137928106 | Medicaid | TX | |
1447372123 | Other | GROUP TX HEALTHSTEP NPI | |
00J21A | Other | TX | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | J2771 (Texas) | Primary |
Entity Name | Memorial Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689630865 PECOS PAC ID: 3072403096 Enrollment ID: O20040316000136 |
Mailing Address | Practice Location Address |
---|---|
Dr Marcelina Rupley, MD 1016 N Virginia St, Port Lavaca, TX 77979-3000 Ph: (361) 552-0325 | Dr Marcelina Rupley, MD 1016 N Virginia St, Port Lavaca, TX 77979-3000 Ph: (361) 552-0325 |
Dr. Jeannine L. Griffin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 North Virginia, Port Lavaca, TX 77979 Phone: 361-552-6721 Fax: 361-552-7463 | |
John William Clinton Iii, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 N Virginia St, Port Lavaca, TX 77979 Phone: 361-522-6721 |