Individual
JOHN A RUTKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3315 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1883
(361) 857-1400
Mailing address
PO BOX 203331, HOUSTON, TX 77216-3331
(281) 784-1111
(281) 784-1555
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
H4664
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139605319
—
TX
01
—
1891783950
TRICARE SOUTH
TX
01
—
8P5513
BCBS PROV. NO.
TX
Enumeration date
10/12/2005
Last updated
06/08/2010
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