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Individual

RICHARD EARL RUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 HARBORSIDE DRIVE, SUITE 120, GALVESTON, TX 77555
(409) 747-7334
(409) 747-9252
Mailing address
400 HARBORSIDE DRIVE, ISLAND PEDIATRICS SUITE 120, GALVESTON, TX 77555
(409) 747-7334
(409) 747-9252

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
J9316
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13519004
TX
Enumeration date
08/02/2006
Last updated
07/08/2007
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