Provider Demographics
NPI:1396471868
Name:RUSH, DANIEL C (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:RUSH
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 COLLEGE PKWY APT 331
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2879
Mailing Address - Country:US
Mailing Address - Phone:318-294-3761
Mailing Address - Fax:
Practice Address - Street 1:2651 WHYBURN DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2418
Practice Address - Country:US
Practice Address - Phone:682-651-5120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1383138225100000X
LA10794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist