Provider Demographics
NPI:1194771154
Name:RICE MEDICAL ASSOCIATES EAST BERNARD
Entity type:Organization
Organization Name:RICE MEDICAL ASSOCIATES EAST BERNARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NOBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-234-5571
Mailing Address - Street 1:703 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:EAST BERNARD
Mailing Address - State:TX
Mailing Address - Zip Code:77435-9400
Mailing Address - Country:US
Mailing Address - Phone:979-234-5571
Mailing Address - Fax:
Practice Address - Street 1:703 MORRIS ST
Practice Address - Street 2:
Practice Address - City:EAST BERNARD
Practice Address - State:TX
Practice Address - Zip Code:77435-9400
Practice Address - Country:US
Practice Address - Phone:979-335-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199128301Medicaid
TX199128303Medicaid
TX199128302Medicaid
TX458871Medicare PIN
TX199128301Medicaid