MEDICARE: DR. RUSTI T HAUGE M.D.

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	2084P0800X	Psychiatry Physician	L4129	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10010837	OTHER	TX	AMERIGROUP
2	2496503	OTHER	TX	UNITED HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639124092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSTI T HAUGE M.D.

Provider Business Mailing Address
First Line	:	5500 GUHN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6161
Country	:	US
Telephone Number	:	713-783-8889
Fax Number	:	713-953-0471

Provider Business Practice Location Address
First Line	:	5500 GUHN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6161
Country	:	US
Telephone Number	:	713-783-8889
Fax Number	:	713-953-0471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	11/28/2011

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