Basic Information
| Provider Information | |||||||||
| NPI: | 1346247301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUPLEY | ||||||||
| FirstName: | MARCELINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5219 CITY BANK PKWY STE 35 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794073545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610333 | ||||||||
| FaxNumber: | 8067820097 | ||||||||
| Practice Location | |||||||||
| Address1: | 416 FRANKFORD AVE | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794164162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610536 | ||||||||
| FaxNumber: | 8067610537 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2005 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | J2771 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 1379281-12 | 05 | TX | MEDICAID | 1447372123 | 01 | GROUP TX HEALTHSTEP NPI | OTHER | 183956502 | 01 | TX | GROUP MEDICAID TXHEALTHSTEP | OTHER | 00J21A | 01 | TX | MEDICARE GROUP NUMBER | OTHER | 1083752059 | 01 | GROUP NPI | OTHER | 137928106 | 05 | TX | MEDICAID | 183956501 | 01 | TX | GROUP MEDICAID | OTHER | 137928101 | 05 | TX | MEDICAID | 137928115 | 05 | TX | MEDICAID |