Individual
DR. REX TREVOR RUSSELL
Active
Individual
DR. REX TREVOR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D61674
MD
207L00000X
Anesthesiology Physician
Primary
M6369
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189456005
—
TX
05
—
408659700
—
MD
01
—
8EH105
BCBS
TX
01
—
P01446716
RR
TX
Enumeration date
06/28/2006
Last updated
08/16/2022
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