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Organization

RUSH FAMILY HEALTH CARE, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD DAVID RUSH (CEO)
(903) 794-7874
Entity
Organization

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
261QP2300X
Primary Care Clinic/Center
Primary
K8971
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144733601
TX
05
145366002
AR
Enumeration date
02/20/2007
Last updated
04/25/2008
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