Individual
RONALD DAVID RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5503 N STATELINE AVE, TEXARKANA, TX 75503-5303
(903) 794-7874
(903) 794-0740
Mailing address
5503 N STATELINE AVE, TEXARKANA, TX 75503-5303
(903) 794-7874
(903) 794-0740
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
K8971
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144733601
—
TX
05
—
145165001
—
AR
05
—
145366002
—
AR
Enumeration date
02/11/2008
Last updated
06/03/2008
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