MEDICARE: RICE MEDICAL ASSOCIATES EAST BERNARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194771154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICE MEDICAL ASSOCIATES EAST BERNARD

Provider Business Mailing Address
First Line	:	703 MORRIS ST
Second Line	:
City	:	EAST BERNARD
State	:	TX
Zip	:	77435-9400
Country	:	US
Telephone Number	:	979-234-5571
Fax Number	:

Provider Business Practice Location Address
First Line	:	703 MORRIS ST
Second Line	:
City	:	EAST BERNARD
State	:	TX
Zip	:	77435-9400
Country	:	US
Telephone Number	:	979-335-4433
Fax Number	:

Authorized Official
Title or Position	:	INTERIM ADMINISTRATOR
Name	:	MR. NOBLE ANDERSON
Credential	:
Telephone Number	:	979-234-5571

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	10/20/2009

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Practice Location Address:

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