Healthcare Provider Details

I. General information

NPI: 1700527207
Provider Name (Legal Business Name): RUSHI N MANKAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12121 RICHMOND AVE STE 110
HOUSTON TX
77082-2420
US

IV. Provider business mailing address

2855 GRAMERCY ST STE 400
HOUSTON TX
77025-1697
US

V. Phone/Fax

Practice location:
  • Phone: 281-493-1733
  • Fax:
Mailing address:
  • Phone: 713-668-6828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberW4890
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: