Individual
DR. MARIDETH CARMELLE RUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6621 FANNIN ST, A2210, HOUSTON, TX 77030-2303
(832) 824-5428
Mailing address
6621 FANNIN ST, A2210, HOUSTON, TX 77030-2303
(832) 824-5425
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2009010536
MO
208000000X
Pediatrics Physician
BP10039485
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
P4810
TX
Other
Enumeration date
04/08/2008
Last updated
03/27/2024
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