Provider Demographics
NPI:1992786479
Name:RUSH, WILLIAM N (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:N
Last Name:RUSH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1819 E BROADWAY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581
Mailing Address - Country:US
Mailing Address - Phone:281-993-9333
Mailing Address - Fax:281-993-0634
Practice Address - Street 1:1819 E BROADWAY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:281-993-9333
Practice Address - Fax:281-993-0634
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2017-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE3155207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX575115AC2LOtherMEDICARE
TX803574OtherBC/BS
TX116342002Medicaid
TX116342002Medicaid
C21419Medicare UPIN