Healthcare Provider Details

I. General information

NPI: 1922338714
Provider Name (Legal Business Name): LIGE B. RUSHING,JR.,M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2009
Last Update Date: 01/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8210 WALNUT HILL LN SUITE 120
DALLAS TX
75231-4405
US

IV. Provider business mailing address

8210 WALNUT HILL LN SUITE 120
DALLAS TX
75231-4405
US

V. Phone/Fax

Practice location:
  • Phone: 214-368-3611
  • Fax: 214-696-3695
Mailing address:
  • Phone: 214-368-3611
  • Fax: 214-696-3695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LIGE BURROUGHS RUSHING JR.
Title or Position: MD
Credential: MD
Phone: 214-368-3611