Provider Demographics
NPI:1215985742
Name:BRUSH, RUTH GOVIER (MD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:GOVIER
Last Name:BRUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 DATAPOINT DR STE 600
Mailing Address - Street 2:P. O. BOX 29441
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5907
Mailing Address - Country:US
Mailing Address - Phone:210-616-7796
Mailing Address - Fax:210-616-7799
Practice Address - Street 1:7700 FLOYD CURL DR
Practice Address - Street 2:RADIOLOGY DEPARTMENT - SL-2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3902
Practice Address - Country:US
Practice Address - Phone:210-616-7796
Practice Address - Fax:210-616-7799
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH21022085R0202X, 2085R0202X
MO20080359752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337764YSHDOtherMEDICARE - STRIC
TX0426637-03OtherMEDICAID / CSHCN - STRG
TXP01303763OtherRAILROAD MEDICARE
TX0426637-04OtherMEDICAID - STRIC
TX0426637-02OtherMEDICAID - STRG
TX337764YSHEOtherMEDICARE - STRG
TXH2102OtherTEXAS MEDICAL LICENSE
TXP01303766OtherRAILROAD MEDICARE