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Individual

JUSTIN DOUGLAS RICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
17201 I H 45 S, SHENANDOAH, TX 77385-3311
(936) 270-2099
Mailing address
17201 I H 45 S, SHENANDOAH, TX 77385-3311
(936) 270-2099

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
N4700
TX
208M00000X
Hospitalist Physician
Primary
N4700
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00J21A
GROUP MEDICARE NUMBER
TX
01
094010801
GROUP MEDICAID
TX
05
907544
TX
Enumeration date
05/07/2008
Last updated
07/21/2022
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