| 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 |