Provider Demographics
NPI:1013895051
Name:RUBALCABA, COSME GABRIEL (MS,RDN,LD)
Entity type:Individual
Prefix:
First Name:COSME
Middle Name:GABRIEL
Last Name:RUBALCABA
Suffix:
Gender:M
Credentials:MS,RDN,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 VAN EATON AVE
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-3305
Mailing Address - Country:US
Mailing Address - Phone:956-642-7992
Mailing Address - Fax:
Practice Address - Street 1:670 VAN EATON AVE
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-3305
Practice Address - Country:US
Practice Address - Phone:956-642-7992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered