=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255671962
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REBECCA R RUE MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2013
-----------------------------------------------------
Last Update Date | 02/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 N HIGHLAND AVE STE 530
-----------------------------------------------------
City | SHERMAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75092-7388
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-957-5437
-----------------------------------------------------
Fax | 903-957-0456
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 837
-----------------------------------------------------
City | HOWE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75459-0837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-957-5437
-----------------------------------------------------
Fax | 903-957-0456
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. REBECCA R RUE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 903-957-5437
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | L3807
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------