# DR. FREDERICK E RUSHFORD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1366440265
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G1528 | TX | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 05/31/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00GF88 | PTAN | TX |
| 05 | — | 033581201 | — | TX |
| 01 | — | 080010027 | MEDICARE RR | TX |
| 01 | — | 45D0492837 | CLIA \# | TX |